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.

After internal billing quality audits, it was determined that physicians were significantly undercoding for the work that had been done. There was also a need to update the compliance plan with clinical documentation strategy.

Two four-hour educational sessions were held five months apart. These sessions covered the foundation of CMS E&M Coding documentation guidelines as well as 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 coding performance before and after the educational seminars.

RESULT: The reimbursement climbed 14% on an annual basis. This produced a revenue increase of $252,000 per year or a 1902% return on investment when revenues were compared to the costs of the programs. The compliance plan was also updated to reflect the training and education for future audits.


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.