tci Part B Insider - 2015 Issue 16

Billing Errors: This MAC's Audit Finds That Some Practices Could Be Collecting More

Downcoding errors mean that these providers are selling themselves short. When you hear that a MAC reviewed a practice’s documentation and found errors, you probably assume that the payer uncovered dozens of upcoded charges. But in some cases, the opposite may be also true. That’s the case with a recent CERT audit summary reported by Part B MAC WPS Medicare, which found a variety of errors including several cases where the practices could have billed higher E/M codes. Downcoding Is Alive and Well WPS Medicare recently released its Fourth Quarter 2014 CERT Error Summary, which reveals the...

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