tci Part B Insider - 2010 Issue 4

HCPCS CODING: Avoid Audit Scrutiny by Billing J Codes Properly

Check out these errors -- and how to steer clear of them. When you think of MACs auditing "high-dollar payments," you're probably envisioning reviews of surgical claims or lengthy hospital visits. But a recent OIG audit revealed something different altogether -- a smattering of claims for injectibles billed improperly. Follow a few hard and fast rules, and you can ensure that your injectible coding stays on the straight and narrow. The facts: The OIG sought to determine whether one MAC's highdollar payments (payments over $10,000) to Arkansas Part B providers in 2005 were appropriate, according to the...

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