Question: Sample Methodology ( by coder? by physician? ) ; Timing ( monthly , quarterly, annually? ) ; Scope ( all services? E&M only? Some combination?

Sample Methodology (by coder? by physician?); Timing (monthly, quarterly, annually?); Scope (all services? E&M only? Some combination?) Number of encounters in sample; Goals of the plan; Inclusion of key areas of concern including: Coding/billing for a higher level of service than was rendered; Coding/billing for services not rendered; and Coding/billing for medically unnecessary services; Credentials of auditing staff; Use of a random or a focused audit (i.e. x encounters per coder per month randomly selected vs. x 99284 codes reported per physician per month). What, if any, comparables you would use and where you would find them. How you would report your findings; To whom you would report your findings; Follow-up plans based upon the findings.

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