tci Part B Insider - 2011 Issue 22

Physician Notes: Button Up Those E/M Claims, CMS Tells Providers

Plus: Wrong NPI type might trigger payer edits.Assigning E/M levels willy-nilly? You might be one of the providers that CMS found who erroneously assigned the wrong E/M code to their claims, causing billions in inappropriate Medicare payments.According to a new MLN Matters fact sheet, Medicare providers billed about $28 billion in E/M services between April 2009 and May 2010, but CMS found that "8.4 percent of those E/M payments were identified as being billed at the wrong code level--either too high or too low," the document states.To end providers' confusion about E/M billing, CMS...

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