FP Report -- April 1999
Yes, but ...
Don't fall outside the bell-shaped curve with your federally funded patients. On the 5-level coding scale, code most of your services at level 3.
That's the advice of a family physician who was investigated by the federal government, she said, because of her high volume of federally funded patients.
Most of them used Medicare, Medicaid, and the Civilian Health and Medical Program for the Uniformed Services.
"If the majority of your practice is federally funded, that increases your risk of being audited," she said, asking not to be named.
Kent Moore, manager of reimbursement issues in the AAFP Socioeconomics Division, assisted her with a 1997 letter clarifying that time is not the determining factor in coding most evaluation and management services.
Moore recently said cases in which family physicians are charged with fraud are rare. "Still, this case highlights how important it is for family physicians to periodically review their coding patterns and make sure their documentation supports their codes," he said.
FP Report is published by the AAFP News Department. Copyright © 1999 by American Academy of Family Physicians.
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