Comprehensive Error Rate Testing (CERT) Focus on CPT 99211

Why This Topic Matters

The article highlights Medicare audit and billing issues that can affect claim payment, documentation review, and compliance processes. It also summarizes administrative form and beneficiary-education updates that may affect day-to-day billing workflows.

Article Sections

1. CERT review focus on CPT 99211

   Discusses Medicare CERT monitoring and the documentation themes associated with review findings related to an evaluation and management service. The section also touches on scenarios where the service may be questioned in relation to other billed services.

2. Proper billing of the same surgical procedure code multiple times on the same day

   Reviews general reporting considerations for repeated surgical services on the same date of service. It also references contractor processing issues and follow-up when duplicate denials occur.

3. New Advance Beneficiary Notice replaces three forms

   Summarizes changes to the Medicare beneficiary notice form and the date on which the revised version becomes effective. The section also notes what legacy forms are replaced.

4. Medicare makes expanded benefits brochure available

   Describes the availability of a Medicare brochure that summarizes selected preventive services for beneficiaries and professionals.

5. Dr. Carter's Corner

   Provides brief author and organizational background information.