tci Medicare Compliance & Reimbursement - 2007 Issue 23

INDUSTRY NOTES: Brace Yourself For More Audits Of Debridement Services

Plus: 60 percent of doctors could scale back on Medicare next year.Red alert: Nearly two-thirds of surgical debridement services didn't meet Medicare requirements in 2004. This cost the program approximately $64 million in improper payments, according to a new report from the HHS Office of Inspector General (OIG). Problems: Practices billed four out of 10 debridements using a code or modifier that didn't accurately reflect the service the physician provided, the OIG says. And 29 percent of services had either no documentation or not enough documentation to figure out whether the services were medically necessary or properly coded...

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