tci Medicare Compliance & Reimbursement - 2019 Issue 6

E/M Coding: Boost Claims Accuracy With CBR Insights

Tip: Benchmark your stats against those of other specialists to fix E/M faults. Denial rates suggest that Medicare claims reviewers aren’t going to stop targeting E/M service codes any time soon. Moreover, if your practice falls outside the state and national averages for use of these codes for whatever reason, you may need to step up your compliance to avoid having your claims pulled for a Medicare audit. Context: “The purpose of the Comparative Billing Report [CBR] is to show providers/suppliers their specific billing pattern data in comparison to peer groups within the state” and the jurisdiction...

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