Medicare Compliance & Reimbursement - 2010 Issue 17
PART B AUDITS: Auditors Review Your Notes Based on the Regs As of the Service Date
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Article Overview
This article discusses Medicare Part B audit review of consultation notes and why the applicable documentation standard depends on the date of service. It is aimed at practices, coders, compliance staff, and auditors who need to understand how historical Medicare rules, CMS guidance, and documentation requests may affect retrospective review of consult services.
Why This Topic Matters
Understanding which year’s Medicare guidance applies during an audit can affect how consultation documentation is assessed and whether records from multiple providers may be requested.
What You Will Learn
- How audit review dates relate to the governing Medicare guidance for consultation services.
- Why historical documentation standards can differ from more recent rules.
- What types of supporting records may be requested during a review of consultation services.
- How documentation sufficiency can affect audit outcomes for consult claims.
Who Should Read This
- Medical coders
- Compliance staff
- Billing staff
- Physicians
- Practice managers
- Auditors
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