Part B Insider - 2013 Issue 4
Critical Care Strategies: Get Ready for Increased Audit Activity On Critical Care Time
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Article Overview
This article explains increased Medicare audit attention on critical care evaluation and management claims, with emphasis on documentation of time and prepayment review activity by a Medicare contractor. It is relevant to physicians, coders, compliance staff, and revenue cycle teams who work with critical care services and payer documentation requirements. The discussion focuses on audit risk trends, local policy awareness, and the types of claim review activity affecting critical care reporting.
Why This Topic Matters
Critical care claims are being reviewed more closely, so organizations that bill these services need to understand the audit environment and documentation expectations. The article helps readers recognize why local payer policy and patient-specific support matter for claim defensibility.
What You Will Learn
- Why critical care claims are drawing increased audit attention
- How prepayment review activity can affect critical care billing
- Why local payer policy review is important for documentation compliance
- What kinds of documentation support are emphasized for critical care services
Who Should Read This
- Physicians
- Medical coders
- Compliance staff
- Billing staff
- Revenue cycle teams
Codes Discussed
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