tci Outpatient Facility Coding Alert - 2017 Issue 3

Catch Your Eye Surgery Coding Errors Before CMS Does

Targets: Overcoding, insufficient documentation for key procedures. Getting your eye surgery coding right has always been a priority and now it’s even more important. Errors in cataract surgery coding in particular have attracted recent unfavorable attention from Medicare— which means claims scrutiny and possible paybacks if they find improper reimbursement. White-hot focus: Cataract surgery with intraocular lens (1 stage) is the top-reported Medicare procedure for ambulatory surgery centers, according to VMG Health’s Multi-Specialty Intellimarker 2016, which means the volume of claims—and the risk of compounded errors and refunds—could be substantial for these services. What CMS...

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