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Controversies in Neurology
January 2000

Medical Record Documentation in 1999: Let's Cooperate

Author Affiliations

VLADIMIRHACHINSKIMD, FRCPC, DScFrom the Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pa.

Arch Neurol. 2000;57(1):130. doi:10.1001/archneur.57.1.130

COOPERATING with the Health Care Financing Administration's (HCFA's) Evaluation and Management (E&M) documentation guidelines project will likely yield more favorable results for neurologists than not cooperating. The fundamental idea behind the guidelines is to ensure that all physicians who perform a given E&M service do the same amount of work, regardless of specialty. These guidelines are a logical extension of the Resource Based Relative Value System (RBRVS), which has determined Medicare physician reimbursement since 1992. The American Medical Association (AMA) oversees the Current Procedural Terminology(CPT) process and the assignment of physician work values to CPT codes, tasks that have entailed many physician-years of effort. Before the RBRVS was established, reimbursement varied by specialty and geography. Cognitive specialties were undercompensated compared with surgical specialties. The RBRVS linked physician reimbursement to physician work in a uniform manner and increased relative reimbursement rates for nonsurgical specialties.

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