The American Medical Association is protesting a decision of the Centers for Medicare and Medicaid Services to have a RAC contractor begin to audit how physicians report evaluation and management services through CPT code 99215.
“We have been informed that in the next several weeks, Connolly, the RAC contractor for Medicare Region C, will begin complex medical review of CPT code 99215 for a Level 5 office visit, and will be permitted to extrapolate their findings based on a statistical sample of such claims,” the AMA notes in a recent letter to CMS Acting Administrator Marilyn Tavenner. “The AMA strongly opposes RAC review of E&M codes, including CPT code 99215, and strongly urges CMS to rescind its approval of RAC review of CPT code 99215 and reject any other pending RAC requests to audit E&M codes.”
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