tci Part B Insider - 2012 Issue 15

E/M Billing: Hospital Nailed for Billing E/Ms That Should Have Been Included in Procedures

Consider these tips to avoid the same fate.If you see a patient in the hospital prior to his surgery, you typically can't count that toward reporting an E/M service--instead, your pre-procedure check-in with the patient will be included in payment for the service you perform.Some hospitals, however, aren't aware of this rule--and the OIG is watching. A recent audit of Georgetown University Hospital in Washington, DC revealed that 21 of 125 selected claims showed errors related to outpatient E/M codes being billed with other services. The E/M services "were not separately payable because they were part of...

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