Case Study

Code Blue Coding was contracted to develop and implement an E&M Coding educational program for the Department of Family Medicine at a nationally-renowned academic medical center.

They discovered, through internal billing quality audits that their Physicians had been significantly under-coding for the work that had been done.

Code Blue Coding provided 2 four hour educational sessions. These sessions, held five months apart, covered the foundation of CMS E&M Coding documentation guidelines as well as various other pertinent topics. These topics included:


  • Established Patient Office Visit
  • New Patient Office Visit
  • Consultations
  • Preventive Care
  • CMS Teaching Rules
  • Billing by Time
  • Care Plan Oversight


The Department of Family Medicine tracked ‘Established Patient Visit’ coding performance before and after the educational seminars.

After the training they stated “We have seen dramatic improvement in both documentation and coding for our established patient visits as a result of this educational effort…”

As a result the reimbursement climbed 14% on an annual basis. This produced a revenue increase of $252,000 per year; which equates to a return on investment of 1902% compared to the cost of the program.

Below is a small table that documents the changes:



I have a better understanding on how to use the auditing tools and how to use them effectively” “The clinical examples were relevant and very useful.”  -Sharon King, D.O.