tci ED Coding & Reimbursement Alert - 2022 Issue Q1

Compliance: ED Physicians’ Coding Errors Decreased, Despite the COVID-19 Pandemic

Incorrect coding was the biggest culprit among ED providers’ claims. Emergency medicine providers not only perform E/M services every day, but they also read imaging studies, perform procedures, and review lab reports — among many other responsibilities. This range of services can lead to a wide swath of coding rules to understand, which could create confusion when selecting the most accurate code. Perhaps this explains the $190 million in improper payments that CMS attributes to emergency department specialists. Background: CMS published its “2021 Medicare Fee-for-Service Supplemental Improper Payment Data” on December 7, 2021, as part of its Comprehensive...

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