Outpatient Facility Coding Alert - 2018 Issue 8
Measure Your Critical Care Numbers Against Your Peers
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Article Overview
This article explains why critical care claims are drawing attention from Medicare contractors and integrity review programs, and why benchmarking billing patterns can help practices assess risk. It is aimed at coders, billers, compliance staff, and physicians who submit critical care services and want to understand the general audit landscape, peer comparison concepts, and the kinds of claim patterns being monitored.
Why This Topic Matters
Critical care claims can face heightened medical review and integrity scrutiny, so understanding the broader oversight environment can help organizations evaluate their billing patterns and documentation processes.
What You Will Learn
- Why critical care claims are being monitored more closely
- Which review and audit programs are referenced in connection with critical care claims
- How benchmarking is used to compare billing patterns
- What types of critical care claim patterns are drawing attention
- Why claims review and documentation quality matter for this service category
Who Should Read This
- Physicians
- Medical coders
- Medical billers
- Compliance staff
- Revenue cycle teams
Codes Discussed
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