tci Medicare Compliance & Reimbursement - 2016 Issue 1

Error Rates: Nail Down Your E/M Claims to Stay Off the Audit Hit List

Relationship with the coder and the education of the physician are critical. The latest CERT report from the Centers for Medicare & Medicaid Services (CMS) indicates that error rates are climbing. The spotlight on evaluation and management (E/M) coding and incident-to billing has not decreased, so practices need to be extra careful with E/M coding and NPP billing. Get the scoop on the CERT findings to shore up your own practice’s coding and billing, so you can avoid audit scrutiny and possible paybacks. Medicare Will Want Refunds The 2014 Medicare Fee-for-Service improper payment rate ratcheted up to 12...

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