tci Medicare Compliance & Reimbursement - 2017 Issue 16

Revenue Booster: Avoid These Top E/M Pitfalls Highlighted in the CERT Report

Hint: Keep the 3 key components in mind when you submit your claims. If your primary revenue comes from billing for evaluation and management services rendered, you may want to step up your coding compliance plan as a preventive measure. Why Is E/M Coding Such a Problem? Context: E/M claims are a major issue for Medicare Part B providers and weigh heavily in the CERT data in the 2016 Medicare Fee-for Service Improper Payment Rate Report out this past July. With a 14.3 percent error rate in 2016, E/M services persist in causing problems for CMS and account...

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