Healthcare Business Management Association - HBMA
Leading the Business of Healthcare Login
E/M: Physician Versus Facility
By Jackie Miller, RHIA, CCS-P, CPC, PCS

A physician practice biller who was concerned about possible inappropriate billing practices at a local hospital contacted a coding consultant. One of the biller's physicians saw a patient in the hospital's outpatient clinic, and the biller was horrified to discover that the hospital had submitted an Evaluation and Management (E/M) code to Medicare for the clinic visit. She explained to the consultant that this was clearly fraudulent billing because only physicians can use E/M codes, and she questioned whether it would be appropriate for her to turn in the hospital to the Office of Inspector General.

Not a Member?

Click here to purchase an annual subscription to our Billing Journal! Click here to purchase an annual
subscription to our Billing Journal!
 
Tell me more! Learn about our member benefits... Tell me more! Learn about
our member benefits...
 
Join Now! Gain immediate access to all online membership benefits. Join Now! Gain immediate access
to all online membership benefits.
Non Members can download one copy of Billing - click here to download yours today! Non Members can download one copy of Billing.
Click here to download yours today!
 
Email the membership department. Email the membership department.

Welcome, Please Sign In
Username:
Password:
Remember Login:

 Return to Issue Index