What is MEAT?

Coding guidelines specify that ICD-10 codes reported on health insurance claims should be supported by the documentation in the medical record in order to qualify for reimbursement.  To properly do so, a patient’s medical record must explicitly state that a condition was Monitored, Evaluated, Assessed or Treated (MEAT).

 

What qualifies for MEAT?

The purpose of MEAT is to ensure that a physician has specifically addressed a patient condition. If an encounter note does not meet the guidelines below, the encounter will not be eligible for payment.

• Monitoring a condition includes discussing the signs, symptoms and progression (or regression) of the disease.
•  Evaluating a condition includes addressing test results, treatment results and medication.
• Assessing a condition involves ordering tests, reviewing records, and counseling the patient.
• Treatment includes prescribing medication or other therapy.

What is the purpose of MEAT?

The purpose of MEAT is to fairly compensate doctors, based on the required level of decision-making during the appointment. A teenager with a sore throat requires far less decision-making than an obese senior with complications from diabetes. The degree of decision-making should be commensurate with the length and complexity of the visit. What happened during the appointment must be thoroughly documented in the patient notes.

What happens my bill doesn’t comply with the MEAT criteria?

Insurance carriers look at the billing trends in each practice. Submitting a higher than normal number of high level E&M codes can trigger an audit. Insurance companies will request charts and – if the documentation does not support the E&M codes submitted– they will recoup payments.

How can I make sure my records are correct?

As a physician, you have the ultimate responsibility for patient records. Training on your EMR system is essential for both you and your staff. You should be reviewing the encounter level for each patient to make sure that it properly reflects the conditions treated and the complexity of the visit.

You can also work with a member of the American Association of Professional Coders, who are highly trained specialists in documentation, billing and health care compliance.

About the Author

Nancy Rowe CPC, CPMA, CRC is the founder and president of Practice Providers Corporation. Her highly-trained staff provide personal and comprehensive medical practice management services – including Coding, clinical documentation training, risk adjustment management coding and managed hosting services. For more information, please call 1-800-959-6628 or email This email address is being protected from spambots. You need JavaScript enabled to view it.