tci Part B Insider - 2008 Issue 20

MEDICARE ERRORS: 99232 and 99211 Top the CERT List of Mistakes

With more than $100 million overpaid for 99232, physicians poorly documented subsequent hospital careIf your favorite code is 99211, watch out. A new CMS report re-veals that more than 15 percent of claims submitted to Part B for this code last year were missing critical documentation, causing Medicare to request more than $20 million back from providers.The CERT report found 99211 (Outpatient E/M that may not require a physician) billed inappropriately across the board, both in the -insufficient documentation- and -no documentation- categories. -Practices may be surprised by this high error rate because many people think it doesn't...

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