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 Inpatient Coding Audit Worksheet. Provider Query Opportunity Yes . No Yes . No Yes . No Male . Female. Pre-Audit. Post-Audit. Diagnosis Coding. PX RC PX. PX. Pre 
 CPT AUDIT TOOL INSTRUCTIONS . • If a form is used and blanks are Good practice for providers is to do a self-audit and to look at other providers in 
 Our E/M coding and documentation courses are designed and narrated by Peter R. Jensen, MD, CPC, founder of E/M University. Dr. Jensen is a practicing physician as 
 NAVMED 6150/46 (01-2010) E/M Code 3. Audit Date. Provider Query Patient Age/Sex. Age: Sex: Comments Date Coded. Coded w/in 15 Days DMIS/Facility. Attending Provider
 as a guide for overall level of E&M Service) prognosis, differential diagnosis, risks, benefits of treatment, instructions, compliance, risk
 Table E.1 - Sample Audit Tool 3. Implementation and operation Level Yes No Findings Comments 3.1 The organization must provide and sustain the infrastructure
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 1995 E/M (Evaluation and Management) Score Sheet Companion The 1995 E&M Score Sheet gives providers a tool to audit medical Can satisfy with patient intake 
 Documentation Guidelines for E&M Services MLN Educational Web Guides. Documentation Guidelines for Evaluation and Management (E/M) Services
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 E/M Documentation Worksheet pg. 1 Created 09/15/00 - Revised 12/26/00 E/M Documentation Auditors' Worksheet Physician's Name and/or ID#: Patient's ID/MR #:
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 Medicare Part B Beneficiary HIC # Provider Number. Date of Service. Procedure Code Reported. M E D I C A L D E C I S I O N M A K I N G ? 4 Extensive: High ? 

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