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Previous Volume 339:1705-1708 December 3, 1998 Number 23 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text Purchase this article Editorial by Kassirer, J. P. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

In July 1998, the Health Care Financing Administration (HCFA) intended to implement a revised and more complex set of guidelines specifying how physicians should code and document "evaluation and management" services billed to Medicare. These services include office visits and hospital visits and are distinguished from surgery and other invasive procedures. In 1996, Medicare payments for evaluation and management services totaled about $16 billion, or 40 percent of payments to physicians under the program.¹

Before the proposed date of implementation, the new guidelines created considerable turmoil among practicing physicians and were a subject of spirited and sometimes angry commentary in . . . [Full Text of this Article]

A Brief History of Evaluation and Management Guidelines

An Overview of the Proposed Guidelines

Four Arguments against the Guidelines

The Guidelines and Clinical Reasoning

Documentation and the Medical Record

Fair Compensation for Clinical Effort

Fraud and Abuse

Conclusions

References

Related Letters:

Evaluation and Management Guidelines
Berenson R. A., Field M. H., Ashcraft M., Wetzler H. P., Loudermilk A., Maddock R. K., Kassirer J. P., Angell M.
Extract | Full Text  
N Engl J Med 1999; 340:889-891, Mar 18, 1999. Correspondence

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