tci ED Coding & Reimbursement Alert - 2019 Issue Q3

Audits: Are Your 99285 Claims Above the Average?

Check the outcomes from this comparative billing report for the scoop. Are most of your claims reported as 99285? Some EDs are billing this high-level code on over 80 percent of their claims — but that far exceeds the average. That’s the word from a new comparative billing report (CBR) compiled by RELI Group, Inc., which CMS contracts to develop, produce, and distribute CBR reports. The firm found that the average percentage of services billed to Medicare with 99285 (Emergency department visit for theevaluation and management of a patient ...) was 46.53 percent. It’s a good...

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