tci Part B Insider - 2019 Issue 5

E/M Coding: Use CBR Insight to Back Up Your Claims

Tip: Turnaround E/M blunders with benchmarking numbers. If you feel like Medicare claims reviewers are targeting E/M service codes, you’re right. Moreover, if your practice falls outside the state and national averages for use of these codes for whatever reason, you may need to step up your compliance to avoid having your claims pulled for a Medicare audit. Context: “The purpose of the Comparative Billing Report [CBR] is to show providers/suppliers their specific billing pattern data in comparison to peer groups within the state” and the jurisdiction they practice in, says Medicare Administrative Contractor (MAC) CGS in...

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