tci Part B Insider - 2016 Issue 2

Compliance: CMS: Stop Reporting Hospital E/M Codes for SNF Visits

Plus: Laparoscopic hernia repairs are under the agency’s microscope. Many providers are so accustomed to either reporting outpatient or inpatient E/M codes that they don’t realize other such codes exist for encounters that fall outside of those two categories. This may have been the cause of a recent audit finding revealing that many practitioners are billing inpatient codes when performing skilled nursing facility (SNF) evaluations. According to the January 2016 Medicare Quarterly Provider Compliance Newsletter, RACs are reporting to CMS that they have seen this issue multiple times. “The Recovery Auditors are finding that physicians and...

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