AMA presses HCFA on E/M code use
February 1, 1999 less than 1 minute read
Focus on Medicare
AMA presses HCFA on E/M code use
The American Medical Association (AMA) is trying to convince the Health Care Financing Administration (HCFA) that the medical record is "not made for payment documentation." The AMA and other medical organizations have been negotiating with HCFA for more than a year about the exact methodology used in Medicare evaluation and management (E/M) codes. HCFA has favored using a numeric system awarding specified points for various aspects of a medical office visit. Following the HCFA approach, physicians would need to document specified totals in order to justify their billings to Medicare. The AMA’s position is to resist any use of numeric formulas, favoring instead a peer review system for review of medical records to determine the appropriate level of care.
HCFA representative Jean Harris says while HCFA was willing to negotiate, it was not interested in a pure peer review model. She says HCFA would, however, work on some pilot plans for alternatives to the current E/M proposals.
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