E/M DOCUMENTATION AUDITORS’ WORKSHEET …

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E/M DOCUMENTATION auditors WORKSHEET 1995 guidelines Member Last Name or Identifying Number ________________ Provider Name _____________________ Date of Service ______________________________ Procedure Code(s) Reported ___________________________ Auditor Agrees Auditor Disagrees Code Assigned by Auditor ______________ Record Audited by Date E/M DOCUMENTATION auditors Instructions Refer to data section (table below) in order to quantify.

E/M DOCUMENTATION AUDITORS’ WORKSHEET 1995 Guidelines ... form someone other than patient and/or discussion of case with another health care provider 2

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