BC Advantage - 2009 Issue 2

Comprehensive Error Rate Testing (CERT) Focus on CPT 99211

Annually, the Centers for Medicare and Medicaid Services monitor the accuracy of Fee-For-Service (FFS) payments. CMS contractors use the Comprehensive Error Rate Testing (CERT) program to determine which services are experiencing high error rates. One particular topic recently highlighted was the incorrect use of evaluation and management code 99211.Per the 2009 Current Procedural Terminology (CPT) manual, 99211 is  "Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician. Usually, the presenting problem(s) are minimal. Typically, 5 minutes are spent performing or supervising these services."...

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