AMA CPT® Assistant - 2010 Issue 11 (November)

Safeguarding Program Integrity (November 2010)

November 2010 page 7 Safeguarding Program Integrity Audits of health care billing have been used for many years as a method to attempt to ensure accurate payment as well as to detect potential fraud. With more attention in recent years, and even more in recent months, on the high costs of health care and the need to rein in spending, the emphasis on reducing inaccurate payments, as well as wasteful, fraudulent, and abusive practices that impact health care resources, has increased. Iinitiatives to reduce health care costs by identifying potential overpayments or billing abuses include: In November 2009, President...

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CPT® Assistant content is the official source for CPT® coding guidance. It is an instrumental tool when appealing insurance denials and validating coding to auditors. Monthly issues and an extensive archive provide comprehensive guidance on proper CPT® coding for past, present and upcoming code set releases. Archives date back to 1990 for historical use of codes, changes, rationales, coding tips and trends in the industry.

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