tci General Surgery Coding Alert - 2019 Issue Q4

Medicare Rules: Avoid Fraud and Abuse Charges

Unbundling is still a trap. Don’t think your practice is immune from Medicare fraud and abuse charges, even if wrong actions are not intentional. Certain procedures you use as you file Medicare claims could put you at risk. Read on to master the difference between fraud and abuse, and to get a refresher on claims-filing behaviors you need to avoid. See What Constitutes Fraud Although you may think of fraud and abuse as the same thing, they are different. “Fraud occurs when someone intentionally falsifies information in an effort to deceive Medicare,” explains Gail O’Leary...

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