tci Medicare Compliance & Reimbursement - 2007 Issue 29

CODING: Discover Why A 'Shadow Audit' Could Be Your Salvation

Avoid 3 deadly sins of coronary intervention documentation.If your arterial stent documentation isn't up to snuff, you should brace yourself for audits.Watch out: Coders billed 20 of 72 arterial stent placements in the outpatient setting incorrectly, according to an October 2005 HHS Office of Inspector General (OIG) report (A-06-04-00091). Overall problems: The OIG found that many stent records lacked information on medical necessity for thrombectomy with angioplasty and stent placement. Also, the OIG found that providers failed to use the proper code for thrombectomy in some cases. In others, the provider tried to bill separately for thrombolysis...

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