tci Medicare Compliance & Reimbursement - 2021 Issue Q4

Compliance: Insufficient Documentation Remains Top CERT Woe

Tip: Back up claims with stronger notes and details. Medical necessity, correct coding, and sufficient documentation equal the Medicare claims trifecta. However, despite the efforts of the most seasoned coders, errors still crop up — and those mistakes stack up to billions in improper payments. Read on for the details. Now: The Centers for Medicare & Medicaid Services (CMS) published its “2021 Medicare Fee-for-Service Supplemental Improper Payment Data” on December 7 as part of its Comprehensive Error Rate Testing (CERT) program. The report breaks down the biggest errors among Medicare claims and covers the causes of the improperly...

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