HCPro, JustCoding Outpatient - 2015 Issue 20 (May)
Healthcare News: Contractors find improper payments for unlisted chemistry code
May 27th, 2015
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Article Overview
This news item summarizes a Medicare CERT special study reported in the Medicare Quarterly Compliance Newsletter. It focuses on claim review findings for a laboratory-related HCPCS code, the role of documentation in the payment error findings, and references related Medicare guidance sources for reporting unlisted chemistry procedures. The article is relevant to billing staff, laboratory coders, compliance teams, and others who handle Medicare Part B claims and supporting records.
Why This Topic Matters
It highlights a compliance review tied to documentation problems on Medicare Part B laboratory claims and points readers to related Medicare guidance materials for this type of service.
What You Will Learn
- How a Medicare CERT special study identified improper payment patterns on a laboratory-related claim type.
- What broad documentation elements were missing in the reviewed claims.
- Which Medicare guidance resources are referenced for further reading on reporting unlisted chemistry procedures.
- How compliance newsletter findings can inform billing and documentation review processes.
Who Should Read This
- Medical coders
- Laboratory billing staff
- Compliance auditors
- Revenue cycle professionals
- Healthcare administrators
- Medicare claims specialists
Codes Discussed
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