URMC / Compliance Office / Education and Tools
Education and Tools
A major focus of the URMC Compliance Program is to support effective documentation and accurate billing for physician/provider services. Specifically, the Compliance Office
- Educates providers and billing personnel about regulations for teaching physicians and documentation/billing for E&M services and clinical procedures
- Develops tools which assist providers with efficient, effective documentation and accurate billing
- Audits/monitors inpatient and outpatient records for compliance with regulations and appropriate selection of billing level
- Enables employees to report non-compliant activities without fear of retribution. For more information about this program, see the Integrity Helpline web page.
2023 Evaluation & Management Guidelines
Inpatient
Inpatient/Observation E&M Guidelines
Inpatient/Observation Consultation Guidelines
Inpatient & Outpatient Level of Medical Decision Making
Split/Shared Inpatient and Observation Workflow
Split/Shared Visit Modifier FS Guidelines
Outpatient
Outpatient E&M Guidelines
Inpatient & Outpatient Level of Medical Decision Making
Split/Shared Outpatient Workflow
Split/Shared Visit Modifier FS Guidelines
Miscellaneous
Medical Decision Making Definitions & Clarifying Terms
Modifier 25 - E&M on the Same Day as a Procedure
Prolonged Service Codes
Home or Residence E&M Guidelines
Nursing Facility Guidelines
Student Documentation Guidelines