Audit Tool

1
Which audit tool do you want to use?* This field is required.Select the audit type you are providing today
All codes on an E/M claim
Procedures, Supplies, and Dx codes (No E/M codes)
None: I've completed audits & have a new comment OR want to check/change my answer
2
Are you auditing the diagnosis for an E/M code?* This field is required.Check "yes" if you are auditing the ICD-10 for an E/M code (but are not auditing the E/M CPT code)
YESNO
3
Who is being audited?* This field is required.
ANDREW KAUFMAN MD
ARIC PARK MD
BINH NGO MD
CHRISTINE COLE MD
LAURA BLUMENTHAL MD
NANCY MOHARRAM PA
SEAN CONDON MD
YASMEEN KABIR MD
4
What is the audit "Visit Number"?* This field is required.
5
BILLING DATA: What did the provider code?* This field is required.Enter every line on the CMS 1500 claim form: CPT/HCPCS, Modifier, Unit, ICD-10-CM Example
6
Email Report to:* This field is required.
example@example.com
7
Is there documentation of a (billable) service rendered?* This field is required.
YESNO
8
Is the documentation signed and dated appropriately?* This field is required.
YESNO
9
Was this an incident to service?* This field is required.
This was not an incident to service
This was a properly authenticated incident to service
This was billed as an incident to service but does not meet the criteria
10
Which E/M audit tool do you want to use?* This field is required.This will customize the audit tool to hide what you don't need to see.
Office Visit
Hospital Admit
Hospital Follow up
Other E/M Category
11
What rules are you using?* This field is required.For Compliance Audits for Due Diligence (reviewing claims prior to 2021) select "Both."
BOTH 2021 CPT and 95/97 DG (i.e. for OV w/ prevent, DUE DILEGENCE reports, etc.)
2021 CPT E/M Guidelines for Office Visits
95/97 DGs (i.e. DOS prior to 2021 or non-OV E/M categories)
12
Was this a "nurse visit"? * This field is required.Did a non-provider (i.e. medical assistant/aid) see an est. patient under the provider's order to give needed patient education or a service necessary to influence the provider's medical decision making?
YESNO
13
Was this service conducted by a physician or provider?* This field is required.
YESNO
14
What is the Patient's documented Status?* This field is required.If not explicit, detail finding in your audit notes.
New Est/Not Documented
15
Reasonable History & Exam documented?* This field is required.Select "no" w/out documentation of hx or exam, and when there is no separately identifiable E/M
YESNO
16
What problem/s are addressed?* This field is required.Check all that apply for this patient's office visit
‘Minor’ (for the purposes of classifying a problem in coding guidelines) is defined as a problem that runs a definite and prescribed course, is transient in nature, and is not likely to permanently alter health status. Common examples may include skin tags, nevi, itchy bug bites, seborrheic keratosis not requiring treatment, etc.
‘Acute’(for the purposes of classifying problems in coding guidelines) is defined as a recent or new short-term problem. Common UNCOMPLICATED examples may include abrasion, impetigo, contact dermatitis, AK requiring treatment, etc. Acute with SYSTEMIC symptoms may include examples such as scabies with anxiety, covid-19 rash with SOB, drug induced exfoliative dermatitis with shaking and chills, etc.
‘Chronic’(for the purposes of classifying a problem in coding guidelines) is defined as a problem with an expected duration of at least a year such as acne, psoriasis, rosacea, BCC or SCC in patients with a history of skin cancer, nummular dermatitis, etc. STABLE conditions are "at goal".
‘Undiagnosed new problem with uncertain prognosis’ (for the purposes of classifying a problem in coding guidelines) is defined as a problem in the differential diagnosis that represents a condition likely to result in a high risk of morbidity. Common examples may include recommending biopsy for a changing pigmented lesion or actinic keratosis.
17
NUMBER & COMPLEXITY OF PROBLEMS* This field is required.What is the correct level (based on highest risk problem)?
2 - Prob/s i.e. • 1 self-limited or minor
3 - Prob/s i.e. • 2+ minor • 1 CH stable • Acute uncomp
4 - Prob/s i.e. • 2 CH stable • CH not@goal • Acute w sys symp • New undx UNK Prog
5 - Prob/s i.e. • CH severe exacerbation • Near term threat to life/bodily function
18
AMOUNT/COMPLEXITY OF DATA* This field is required.What is the correct level?
2 - Data i.e. • Less than Two counts or None
3 - Data i.e. • Two counts •OR req. historian
4 - Data i.e. • Three counts •OR interpretation •OR discussion
5 - Data i.e. • Three counts •AND interpretation •OR discussion
19
RISK OF PT MANAGEMENT* This field is required.Concern regarding the likelihood of a side effect from the recommended treatment to cause long-term function impairment, diminished quality of life, permanent organ damage, or death. What is the correct level (based on highest treatment risk)?
2 - Risk i.e. • none
3 - Risk i.e. • OTC • minor Sx without risk fac
4 - Risk i.e. • Rx mgmt. • minor Sx c risk fac • major Sx s • social deter.
5 - Risk i.e. • medication toxicity management • DNR
20
Put it together:

Unless coding on time, to qualify for a particular level of medical decision making, two of the three elements for that level of medical decision making must be met or exceeded. You selected:

{numberamp355}

{amountcomplexityOf}

{riskOf}
21
Was time documented for this established patient?* This field is required.Same DOS only. Shared/split visits/staff time=not counted.
Less than 10 minutes
10-19 minutes
20-29 minutes
30-39 minutes
40-54 minutes
55-69 minutes
1 hour + 25 minutes
1 hour + 39 minutes
More than 1 hour+ 40 minutes
NO
22
Established Patient - Suggested level by time: {wasTime112}
23
Was time documented for this new patient?* This field is required.Same DOS only. Shared/split visits/staff time=not counted.
Less than 15 minutes
15-29 minutes
30-44 minutes
45-59 minutes
60-74 minutes
1 hour + 15-29 minutes
1 hour + 30-44 minutes
1 hour + 45-59 minutes
More than 2 hours
NO
24
New Patient - Suggested level by time: {wasTime110}
25
Enter the correct 2021 CPT E/M (and modifier) * This field is required.Enter one office visit E/M code with modifier. Nothing supported = "none" NOTICE: ICD-10 and other codes are entered elsewhere.
Enter only one code: the E/M code w/ modifier (i.e. 99215-25)
26
DUE DILIGENCE AUDITS NEED ADDITIONAL E/M DATA

You Selected to Audit this Office Visit by both the 2021 CPT guideline & the 95/97 DGs.

The audit findings and results have been captured for the 2021 guideline rules.

Now we must collect additional data to capture the audit findings and results for the 95/97 DGs.

CLICK NEXT TO CONTINUE
27
Do the E/M concepts of HPI, ROS, and MDM apply?* This field is required.
YESNO
28
95 DG History - HPI* This field is required.
Location
Quality
Severity
Timing
Context
Mod Factors
Duration
Asso. S&S
Following 3 Chronic
Following 1 or 2 Chronic
There is no documented CC
29
Math on HPI* This field is required.
30
95 DG History -ROS* This field is required.
CONSTIT
EYES
ENMT
CARDIO
RESPIR
GI
GU
MS
SKIN
NEURO
PSYCH
ENDO
HEMAT/LYMPH
ALLERG/IMMUNO
None
31
Math on ROS* This field is required.
32
95 DG History -PFS* This field is required.
Past
Family
Social
None
33
Math on PFS* This field is required.
34
95 DG Level of History* This field is required.
35
Do you want to skip the 95 Exam DGs?* This field is required.Click "yes" if you want to skip to 97 DGs
YESNO
36
95 DG Exam - OS* This field is required.Organ Systems
Organ System: CONSTITUTIONAL
Organ System: EYES
Organ System: ENMT
Organ System: CARDIOVASCULAR
Organ System: RESPIRATORY
Organ System: GASTROINTESTINAL
Organ System: GENITOURINARY
Organ System: MUSCULOSKELETAL
Organ System: SKIN
Organ System: NEUROLOGIC
Organ System: PSYCHIATRIC
Organ System: HEM/LYM/IMMU
None
37
95 DG Exam - BA* This field is required.Body Areas
Body Area: head/face
Body Area: neck
Body Area: back
Body Area: abdomen
Body Area: genitalia
Body Area: chest/axillae/breast
Body Area: RT Upper extremity
Body Area: LT Upper extremity
Body Area: RT Lower extremity
Body Area: LT lower extremity
None
38
Was the 95 DG exam extended?* This field is required.Alternately was this exam "detailed" (i.e. the 4x4 definition)?
YESNO
39
Was the exam a 95 DG comprehensive single system exam?* This field is required.Was a complete examination of a single organ system documented?
YESNO
40
Level of DG 95 Exam* This field is required.
41
Do you want to use the 97 DGs for Dermatology Exam?* This field is required.
YESNO
42
1997 Skin Exam - Constitutional
Constitutional: Vitals x 3
Constitutional: Patient’s General Appearance
43
1997 Skin Exam - General
Eyes: Inspection of conjunctivae/lids
Neck: Exam of thyroid
Cardiovascular: Exam of PVS by observation/palpation
Extremities: Inspection/palpation of digits/nails
Lymphatic: Palpation of lymph nodes in neck, axillae, groin/other
44
1997 Skin Exam - Neuro/Psych
Neuro/Psych: Orientation to time, place/person
Neuro/Psych: Mood/affect
45
1997 Skin Exam - GI
GI: Exam of liver/spleen
GI: Exam of anus for condyloma/other lesions
46
1997 Skin Exam -ENMT
ENMT: Inspection of lips, teeth/gums
ENMT: Exam of oropharynx
47
1997 Skin Exam
Skin: Palpation scalp/inspect scalp hair, eyebrows, face, chest, pubic if needed, extremities
Skin: Inspect/palpation of skin/subcutaneous tissue Head, including the face
Skin: Inspect/palpation of skin/subcutaneous tissue Neck
Skin: Inspect/palpation of skin/subcutaneous tissue Chest/breasts/axillae
Skin: Inspect/palpation of skin/subcutaneous tissue Abdomen
Skin: Inspect/palpation of skin/subcutaneous tissue Genitalia, groin, buttocks
Skin: Inspect/palpation of skin/subcutaneous tissue Back
Skin: Inspect/palpation of skin/subcutaneous tissue Right upper extremity
Skin: Inspect/palpation of skin/subcutaneous tissue Right lower extremity
Skin: Inspect/palpation of skin/subcutaneous tissue Left upper extremity
Skin: Inspect/palpation of skin/subcutaneous tissue Left lower extremity
48
Math for general* This field is required.
49
Math for GI* This field is required.
50
Math for Neuro* This field is required.
51
Math for Constit* This field is required.
52
Math for ENMT* This field is required.
53
Math for 97 Skin Count for Comp* This field is required.
54
Math for 97 Bullet Count* This field is required.
55
Math for 97 Bullet Count to determine comp* This field is required.
56
Level of DG 97 Exam* This field is required.
57
Math on Organ Systems* This field is required.
58
Math on Organ Systems and Body Areas* This field is required.
59
95 DG MDM # of Dx* This field is required.What type of Dx is/are documented?
Minor
Est. stable
Est.worsening
New no workup
New w/workup
60
How many minor problems?* This field is required.Credit will max at 2
61
Math to round down minor problems* This field is required.Credit will max at 2
62
How many established stable problems?* This field is required.
63
How many established worsening problems?* This field is required.
64
Math on established worsening problems* This field is required.
65
Math on New Problem* This field is required.
66
Math on New Problem with work up* This field is required.
67
Total on Dx* This field is required.
68
What type of data is considered?* This field is required.95 DGs
Labs test ordered or reviewed
CPT® Med Test- ordered/reviewed
CPT® Radio Test- ordered/reviewed
Discuss w performing/consulting Dr
Obtain old records/additional hx
Summary of old records/add hx
Independent interpretation of test
None
69
How many labs/records ordered/reviewed, discussed?* This field is required.
70
Math on old records* This field is required.
71
Math on independent interpretation 2 points * This field is required.
72
Total on Data* This field is required.
73
What is the level of Risk?* This field is required.95 DGs
SF: Clinical testing/management examples: Venipuncture, X-ray, EKG, U/A, U/S, rest, superficial dressings, elastic bandage, gargles, etc. Presenting Problem Example: 1 minor / self limited
Low: Clinical testing/management examples: Biopsy, pulmonary function, barium enema, minor surgery without risk factors, OTC drugs, PT, OT, IV without additives, etc.Presenting Problem Example: 1 –2 minor, 1 stable chronic / 1 acute uncomplicated
Moderate: Clinical testing/management examples: Stress tests, endoscopies, cardiovascular imaging, centesis, closed Tx of Fx, Rx drug management, minor surgery with risk factors, major electivesurgery without risk factors, therapeutic radiation tx, etc.Presenting Problem Example: 1 chronic exacerbated / 2 stable chronic / New Undiagnosedwith uncertain outcome / Acute with systemic symptoms / acute complicated injury
High: Clinical testing/management examples: Cardiovascular imaging with risk factors, endoscopies with risk factors, discography, medication toxicity management, major surgerywith risk factors, emergency surgery with risk factors, etc.Presenting Problem Example: 1+ chronic severely exacerbated / Illness or injury that poses athreat to life / Abrupt change in neurological status
74
Total on Risk* This field is required.
75
Math on middle* This field is required.
76
Level of 95 DG MDM* This field is required.
77
Was time documented with the 95/97 Audited E/M?* This field is required.
YESNO
78
How many minutes were documented?* This field is required.
79
Does time support the level of service that was coded?* This field is required.
YESNO
80
New Patient: Auditor Quick Reference Review

Your audit shows:

HISTORY
➽{95Dg} EXAM95
➽{levelOf} MDM
➽{levelOf281}

EXAM97
➽ {levelOf307}

Minutes: {howMany169}
Counseling/COC Time was documented at 50%+: {doesTime}

This is only a reference: This chart is a quick reference to show the requirements for this E/M category. Review your findings to determine the level based on the requirements. All 3 criteria (Hx, Exam, MDM) must be met to select a level of service for this category or default to the lowest of the 3 criteria unless time is documented as 50% or more in counseling or coordination.
81
Hospital Admit: Auditor Quick Reference Review

Your audit shows:

HISTORY
➽{95Dg}
EXAM95
➽{levelOf} MDM
➽{levelOf281}

EXAM97
➽ {levelOf307}

Minutes: {howMany169}
Counseling/COC Time was documented at 50%+: {doesTime}

This is only a reference: This chart is a quick reference that shows the requirements for this E/M category. Review your findings to determine the level based on the requirements. All 3 criteria (Hx, Exam, MDM) must be met to select a level of service for this category or default to the lowest of the 3 criteria unless time is documented as 50% or more in counseling or coordination
82
Established Patient: Auditor Quick Reference Review

Your audit shows:

HISTORY
➽{95Dg} EXAM95
➽{levelOf} MDM
➽{levelOf281}

EXAM97
➽ {levelOf307}

Minutes: {howMany169}
Counseling/COC Time was documented at 50%+: {doesTime}

This is only a reference: This chart is a quick reference that shows the requirements for this E/M category. Review your findings to determine the level based on the requirements. The 2 of the 3 criteria (Hx, Exam, MDM) must be met to select a level of service unless time is documented as 50% or more in counseling or coordination.
83
Hospital Follow Up: Auditor Quick Reference Review

Your audit shows:

HISTORY
➽{95Dg} EXAM95
➽{levelOf} MDM
➽{levelOf281}

EXAM97
➽ {levelOf307}

Minutes: {howMany169}
Counseling/COC Time was documented at 50%+: {doesTime}

This is only a reference: This chart is a quick reference that shows the requirements for this E/M category. Review your findings to determine the level based on the requirements. 2 of the 3 criteria (Hx, Exam, MDM) must be met to select a level of service unless time is documented as 50% or more in counseling or coordination
84
AUDITOR FINDING: What is the 95/97 DG E/M w/ Mod?* This field is required.Only enter one office or hospital visit E/M code and modifier. Other services and ICD-10 with audit results are entered elsewhere.
Enter only one code: the hospital or office visit code w/ modifier (i.e. 99215-25)
85
Did the doctor code the ICD-10 correctly with the E/M?* This field is required.Answering yes will customize the audit tool to hide what you don't need to see
YESNO/Not Known
86
AUDITOR FINDING: Enter the correct ICD-10-CM(s) for the E/M visit* This field is required.If entering multiple codes, the first Dx code you enter will be considered PRIMARY
87
Does the documentation support any (Non-E/M) CPT/HCPCS service/s?* This field is required.
YESNO
88
AUDITOR FINDING: Were all (Non-E/M) CPT/HCPCS coded correctly?* This field is required.(i.e. Procedures and/or Supplies)
Yes
No
N/A
89
AUDITOR FINDING: Were all (Non-E/M) ICD-10-CM coded correctly?* This field is required.(i.e. the Diagnosis for the procedures and supplies)
Yes
No
N/A
90
Audit Result: What is the correct CMS 1500 line data for each (non-E/M) procedure and/or supply?* This field is required.Enter on each line: CPT/HCPCS, Modifier, Units, ICD-10-CM
91
AUDITOR FINDING: Claim Payment Accuracy* This field is required.Was the entire CMS 1500 coded properly to result in the correct payment for services provided? If dual auditing "old" +"new" E/M rules: "Pass"=only if BOTH versions pass otherwise use NA.
Pass
Fail
NA
92
What is the failure type?* This field is required.
Payer over payment request is possible
An under payment appears possible
Both over and under payment possibilities are identified
Other - As stated in comments
93
What was the cause of the failure?* This field is required.Check ALL that apply and detail in your audit finding notes
Wrong/missing Provider (i.e. different doctor, incident-to, teaching, 99211)
Wrong/missing Date of Service
Wrong/missing Modifier
Wrong/missing CPT/HCPCS code
Wrong/missing ICD-10-CM code
Wrong/missing units
Illegible/missing/unacceptable signature/s
Unbundling (Medicare NCCI procedure to procedure (PTP) edits)
Insufficient/missing documentation
E/M: The "new" status of the patient is not explicit in the document
E/M: No separately identifiable E/M is documented
E/M: Wrong code category (i.e consultation vs office visit)
E/M: Wrong CPT EM level
E/M: No Chief Complaint
Other - As stated in comments
94
Primary reference that supports audit findings:* This field is required.Which reference should be included on your report?
95
Want a second reference from the drop down list?* This field is required.If you want to add another reference from the short list select: "yes"
YESNO
96
Secondary reference that supports audit findings:* This field is required.Which reference should be included on your report?
97
Want to add a third reference from the drop down list?* This field is required.If you want to add another reference from the short list select: "yes"
YESNO
98
Third reference that supports audit findings:* This field is required.Which reference should be included on your report?
99
Educational Opportunities/InformationCheck all that apply and detail in your audit finding notes
SUBJECTIVE DETERMINATIONS - This auditor allowed implied elements where another might request additional documentation (detailed in Audit Findings.) Concise documentation is recommended to avoid payer audit findings that require peer review, appeal, additional time, and/or cost.
ICD-10 UNCERTAIN VERSUS UNSPECIFIED - This auditor observed the documented use of D48.5 Neoplasm of “uncertain” behavior of skin. Uncertain has a specific meaning in ICD-10. It means that the specimen has been examined by the pathologist and it can’t be determined if the neoplasm is benign or malignant. An uncertain neoplasm is reported after the pathologist’s report, not when sending the specimen for biopsy. D49.2 Neoplasm of unspecified behavior of bone, soft tissue, and skin is what this auditor expected to see listed.
AMOUNT AND COMPLEXITY OF DATA IS SEPARATELY IDENTIFIABLE: This auditor assumes that the lab/s ordered are not also being separately billed by the same provider/group during the same encounter. If the provider/group bills for the test done during the patient encounter, the provider does not get credit in MDM for the lab order or reviewing the results.
MEDICATION TOXICITY MONITORING - If the provider documents that the patient is at high risk regarding the likelihood of side effects from medication to cause long-term function impairment, diminished quality of life, permanent organ damage, or death, the provider will qualify for a “high” level of risk under the component of “Risk of Complications and/or Morbidity or Mortality of Patient Management”. However, toxicity monitoring is only one of two required aspects under Medical Decision Making and two are required for a level 5.
STABLE VERSUS NOT AT GOAL - This auditor recommends updating EHR terms and using specific language regarding problems that are “Stable.” STABLE for the purposes of categorizing medical decision making is defined by the specific treatment goals for an individual patient. A patient that is not at their treatment goal is not stable, even if the condition has not changed and there is no short-term threat to life or function. A stable problem often supports a level 3 office visit, whereas a problem not a goal often supports a level 4 office visit. Unless the auditor is a medical peer, auditors will classify a problem as stable when it is expressly documented, or when documentation does NOT state that the problem is not at goal, acutely worsening, poorly controlled, not responding as expected to treatment, and/or requires additional supportive care.
MINOR VERSUS ACUTE VERSUS CHRONIC - This auditor recommends updating EHR terms for the purposes of classifying a problem per 2021 coding guidelines. ‘Minor’ (for the purposes of classifying a problem in coding guidelines) is defined as a problem that runs a definite and prescribed course, is transient in nature, and is not likely to permanently alter health status. A minor problem often supports a level 2 office visit. ‘Acute’ (for the purposes of classifying uncomplicated problems in coding guidelines) is defined as a recent or new short-term problem with LOW risk of morbidity. An acute uncomplicated illness often supports a level 3 office visit. ‘Acute’ (for the purposes of classifying an illness with systemic symptoms in coding guidelines) is defined as an illness with systemic symptoms (excluding minor general symptoms). An acute illness with systemic symptoms often supports a level 4 office visit. ‘Chronic’ (for the purposes of classifying a problem in coding guidelines) is defined as a problem with an expected duration of at least a year and is further defined as stable or not.
NON-PHYSICIAN PRACTITIONER SERVICES: This auditor was not given payer contract details as part of this audit. If "incident to" billing rules apply, the documentation must demonstrate that the service is an integral aspect of the MD’s medical plan and that modifiers are used as indicated by payer requirements. New problems require a face-to-face patient encounter with the MD.
RECORDS MUST BE LEGIBLE AND COMPLETE: All entries in the medical record must be legible. Orders, progress notes, nursing notes, or other entries in the medical record must be available and legible to meet billing requirements and to prevent medical errors or other adverse patient events.
DICTATION RECOMMENDED: Handwritten and difficult to read. This auditor recommends sending dictation verbatim if a payer audit is requested to avoid a denial and appeal process.
CLONING: Copying and pasting or other duplicative carry-forward techniques used in medical records will often trigger a fraud or abuse audit to investigate. The medical record must contain documentation showing the differences and the needs of the patient for each visit or encounter. Simply changing the date on the EHR without reflecting what occurred during the actual visit is not acceptable
DOCUMENTATION DETAIL: Documentation lacks detail and could be resulting in a lower code than what was actually provided.
E/M CORRECT AT THE TIME BILLED: This provider passed the audit using the 95/97 DGs, which were in effect when it was billed and there is no overpayment suspected. This provider would NOT PASS WITH THE 2021 RULES.
E/M NOT CORRECT AT THE TIME BILLED: This provider failed the audit using the 95/97 DGs, which were in effect when it was billed and there is no overpayment suspected. This provider would PASS WITH THE 2021 RULES.
NCCI EDITS: The CMS annually updates the National Correct Coding Initiative Policy Manual for Medicare Services. The NCCI Policy Manual should be used by this provider with careful review of the CMS Column One/Column Two Correct Coding edit file to avoid unbundling a payment that result in an inappropriate overpayment or missing allowed codes that can result in underpayments.
MOHS WITH PATHOLOGY: Mohs codes17311-17315 and Surgical Pathology 88302-88309, 88331-88332, 88341-88342 or 88344 on tissue used for margin evaluation during Mohs surgery is inappropriate because it is already included in payment for the Mohs. An exception is made for nonroutine histochemical stain on frozen tissue during Mohs surgery and is appropriate in certain circumstances (such as melanoma) that require the special stains, which would then be reported with 88314-59. However, no documentation of this was provided in this case.
DISCOUNTS: You can charge self-pay patients less than Medicare if the lower charge is not your “usual and customary fee” ---however, this should be adjusted at the fee level, not the code level.
MODIFIER 95: This auditor finds no documentation to confirm the use of interactive, real-time audio visual or that it occurred on an approved platform (i.e. not on Facebook video).
100
What are your Comments?* This field is required.What notes should be included in the audit report (and yourself in the event of a provider education session or expert witness request)?
No further comments.
Huge
Large
Normal
Small
Ok
Ok
101
Visit # Provider Coded Result

{whatIs327} {ltstronggtbillingDataltstronggt} {ltstronggtauditorFinding365}

You said the 2021 E/M code is:{enterThe284}

{numberamp355}

{amountcomplexityOf}

{riskOf}

{whatProblems13}

Time - Est: {wasTime112} New:{wasTime110}

You said the 95/97 DG E/M code is: {ltstronggtauditorFindingltstronggt176}

Hx: {95Dg}

Exam: 95- {levelOf}, 97- {levelOf307}

MDM: {levelOf281}

Minutes documented: {howMany169}

You said the procedures documented were:

{ltstronggtauditResultltstronggt}

You said the failure reasons were:

{whatWas}

{educationalOpportunitiesinformation}
102
What is your Auditor ID?* This field is required.Enter your initials
Should be Empty:

HISTORY ➽{95Dg}	EXAM95 ➽{levelOf}	MDM ➽{levelOf281}
	EXAM97 ➽ {levelOf307}

Visit #	Provider Coded	Result
{whatIs327}	{ltstronggtbillingDataltstronggt}	{ltstronggtauditorFinding365}