American College of Physicians: Internal Medicine — Doctors for Adults ®

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ACP will work to modify 'punitive' E/M guidelines

From the February 1998 ACP Observer, copyright © 1998 by the American College of Physicians.

Noting that HCFA's new guidelines for documenting evaluation and management (E/M) codes billed to Medicare are excessive and "have little relationship to clinical care," ACP's Board of Regents last month said ACP will work to modify the rules.

As currently planned, the new E/M documentation guidelines will be enforced starting July 1. College leaders said they were particularly concerned that the purpose of these guidelines, which were developed jointly by the AMA and the federal government, seem to be more punitive than educational. HCFA plans to conduct prepayment audits of a 1% sample of doctors' records and deny payment if these documentation guidelines are not followed adequately. This action "will subvert the primary use of the medical record as an instrument of clinical care," the Regents concluded.

The Board said the College will work with other medical societies to develop specific recommendations for changes that could reduce the burden of the guidelines. ACP will also push HCFA to find a non-punitive way to assure consistent and documented use of E/M codes.

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