tci ED Coding & Reimbursement Alert - 2018 Issue 3

Part B Payments: CMS: ED Practitioners Log Among the Highest Improper Payment Rates

The agency says EDs improperly billed over $315 million to Part B. Emergency departments are known for putting patient health first, above all other priorities, but CMS is suggesting that perhaps EDs should also dedicate a bit more time to their coding and billing processes. Emergency physicians ranked eighth on CMS' list of specialties with the highest Part B improper payment rates, logging a 12.7 percent rate last year that represented $315.3 million in inappropriate charges. The backstory: CMS issued its "2017 Medicare Fee-for-Service Supplemental Improper Payment Data" in December as part of its Comprehensive Error Rate...

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