Surviving the E&M Quagmire

Postponement or No, Physicians Need To Get a Head Start on Learning Documentation. By Bonnie Darves. When the Health Care Financing Administration announced in April that it was indefinitely postponing implementation of its controversial and much-maligned Medicare Documentation Guidelines for Evaluation and Management Services, commonly called E&M guidelines, a collective sigh of relief arose in many quarters of the medical community. But many believe the postponement—and the promise of streamlined, more physician-friendly guidelines—will have little effect on the current climate in which physicians are increasingly under scrutiny for possible fraud and abuse.. "Government scrutiny will increase, despite HCFA’s assurances otherwise," says Lee McCormick, MD, president of the Pennsylvania Medical Society and an outspoken critic of the new guidelines. HCFA’s announcement that doctors won’t be penalized for innocent coding mistakes is a message "that doesn’t give a lot of comfort," McCormick maintains. . At issue are two problems: Adhering to the 1997 guidelines, released last November and initially slated for implementation in July, has proved a paperwork nightmare for physicians; and recent data from the government’s ongoing audit of physician documentation for Medicare E&M services shows that six out of ...

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