Answer these questions and write a page long analysis of the Financial Impact of Evaluation and Management Coding Audit
1. Overall, did the clinic overcharge or undercharge? By how much?
2. What is the standard fee for an EM visit assigned code 99204
3. Prior to the audit, what is the total amount the clinic charged for code 99215?
4. Which EM Code was overused the most?
5. Which EM Code was underused the most?
Financial Impact of Evaluation and Management Coding Audit
CPT CODE ORIGINAL NUMBER OF CASES FEE TOTAL CHARGES ($) NUMBER OF CASES AFTER AUDITING/RECODING TOTAL CHARGES ($) VARIANCE ($)
99201 151 $40 $6,040 240 $9,600 $3,560
99202 68 $55 $3,740 135 $7,425 $3,685
99203 93 $90 $8,370 61 $5,490 ($2,880)
99204 34 $125 $4,250 8 $1,000 ($3,250)
99205 2 $150 $300 1 $150 ($150)
99211 364 $30 $10,920 334 $10,020 ($900)
99212 335 $40 $13,400 581 $23,240 $9,840
99213 174 $65 $11,310 20 $1,300 ($10,010)
99214 122 $90 $10,980 1 $90 ($10,890)
99215 9 $125 $1,125 0 $0 ($1,125)
99241 85 $125 $10,625 50 $6,250 ($4,375)
99242 44 $145 $6,380 10 $1,450 ($4,930)
99243 60 $150 $9,000 0 $0 ($9,000)
99244 27 $175 $4,725 0 $0 ($4,725)
99245 11 $200 $2,200 0 $0 ($2,200)
TOTALS: 1579 $1,605 $103,365 1441 $66,015 ($37,350)
