tci Part B Insider - 2016 Issue 29

WPS Medicare Identifies This Major Coding Problem Among ENTs

Hint: Don’t skimp on documentation. Most coding experts have heard the old adage, “If it wasn’t documented, it wasn’t done.” But some ENTs may have forgotten this famous mantra, and one payer is watching. WPS Medicare, which provides Part B coverage in Michigan and Indiana, recently revealed the results of its Comprehensive Error Rate Test (CERT), and found that 100 percent of the problems discovered among otolaryngology claims involved insufficient documentation. For instance:WPS noted that an otolaryngologist administered immunotherapy injections and reported 95117 (Professional services for allergen immunotherapy not including provision of allergenic extracts...

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