tci Medicare Compliance & Reimbursement - 2020 Issue Q4

Benchmarking: Find Out If Your NPs’ High-Level E/M Reporting Is Above Average

Caution: Don’t use the same code for every visit. Chances are your nurse practitioners (NPs) are performing higher-level E/M services every day. Plus, because these codes are perennial favorites, they sit atop most Medicare claims reviewers to-do lists. To avoid issues down the road, you may want to periodically review if your NPs are documenting and reporting these codes appropriately. That’s what auditors sought to determine as part of a new comparative billing report (CBR) compiled by RELI Group, Inc., which the Centers for Medicare & Medicaid Services (CMS) contracts to develop, produce, and distribute CBR reports...

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