tci Medicare Compliance & Reimbursement - 2012 Issue 8

Billing: CMS to Institute Payment Edits for E/M Services During Global Periods

When RACs find massive errors, MACs listen. Starting this July, modifiers will be more important than ever for E/M services you perform during surgical global periods. That's because CMS is taking a cue from the recovery audit contractors (RACs) and will soon be putting edits on your claims for these services to reduce improper payments. According to two separate CMS transmittals (1051 and 1052, both updated recently), CMS reviewed the issues that RACs identified as the sources of "significant improper payments" and the agency hopes that new edits will cut down on these problems. CMS highlighted the following topics...

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