tci Part B Insider - 2012 Issue 28

Part B Errors: Assigning the Wrong E/M Code to Your Claims? You're Not Alone, CMS Says

Joint replacements, pacemakers also log high error rates. Would your practice be comfortable with a 9.2 percent error rate? Probably not--and neither is CMS. In its latest Comprehensive Error Rate Testing (CERT) results, CMS reveals that $7.8 billion was improperly paid in 2011, resulting in a 9.2 percent Part B error rate. Of the claims paid in error, CMS identified that the vast majority of overpayments to Part B practices were overpayments, and less than $1 billion were in underpayments. If you received an overpayment, chances are that your MAC will be asking for money back--if...

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