decisionhealth Newsletters, Coder Pink Sheets - 2012 Issue 7 (July)
Online only: 99% error rate for facet injections shows the importance of documentation
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Article Overview
This short practice-management article summarizes a Noridian pre-payment review of facet injection claims and explains why documentation problems led to widespread denials. It is aimed at physicians, billing staff, and coders who submit Medicare claims for interventional pain procedures and want to understand the general compliance and documentation issues highlighted by the audit.
Why This Topic Matters
The article signals heightened audit scrutiny for facet injection claims and shows how documentation gaps can affect claim survival in pre-payment review.
What You Will Learn
- What a Medicare pre-payment review found for facet injection claims
- Why documentation requests and operative notes matter in audit review
- How repetitive or non-specific charting can create compliance risk
- What kinds of documentation issues were associated with claim denials
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Physicians performing interventional pain procedures
- Practice managers
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