MEDICARE ERRORS: 99232 and 99211 Top the CERT List of Mistakes

Subscribe or sign in to view the full article.

Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This article reviews a CMS CERT report highlighting evaluation and management claims that were frequently paid incorrectly, with emphasis on documentation problems and undercoding patterns. It is aimed at coders, billers, compliance staff, and practice administrators who want to understand which service categories drew Medicare scrutiny and why these findings matter for auditing and documentation review.

Why This Topic Matters

The article helps readers identify where Medicare found the most frequent claim errors so they can prioritize documentation review, compliance monitoring, and internal education. It is especially relevant for practices that bill outpatient, hospital, emergency department, and nursing facility E/M services.

Article Sections

  1. 99211 and documentation-related errors

    Discusses CMS findings related to a commonly billed outpatient evaluation and management service and the types of documentation problems identified in the report.

  2. 99232 also on the list

    Summarizes Medicare’s findings for a subsequent hospital care service and the broader documentation issues associated with hospital visit reporting.

  3. Practices undercoded as well

    Reviews the report’s discussion of claims that were paid too low and the service categories most often associated with those undercoding findings.

What You Will Learn

  • Which general claim categories were highlighted in the CERT report
  • How documentation problems contributed to Medicare claim errors
  • Which broad E/M service settings were involved in the findings
  • Why undercoding can also appear in Medicare error reviews

Who Should Read This

  • Medical coders
  • Medical billers
  • Compliance staff
  • Practice managers
  • Physicians and other providers

Codes Discussed


Subscribe or sign in to view the full article.

Keep pace with evolving Medicare regulations — and onboard your team — with timely analysis of critical updates interpreted in an easy-to-follow, easy-to-apply format. Your subscription to TCI's Medicare Compliance & Reimbursement Alert will equip you to navigate code and guideline changes, CCI edits, and revisions to modifiers, payer policies, the fee schedule, OIG target areas, and more.

  • Current newsletters added each month
  • Fully searchable archives - over 4200 articles
  • ALL years/issues back to 2003 organized by year and issue
  • Codes mentioned in articles are linked to Code Information pages
  • Code Information pages link back to related articles

This feature is currently unavailable for online purchase. For more information, please call 801-770-4203 or Contact Us.

Related Articles

Articles are listed in order of calculated relevance.

demo
request yours today
subscribe
start today
newsletter
free subscription

Thank you for choosing Find-A-Code, please Sign In to remove ads.

Aimee- AI -powered coding assistant - Try it now for Free Would you like Aimee - AI
to help you with this?