tci E/M Coding Alert - 2018 Issue 6

Auditing: Avoid Audit Agony with This Modifier Advice

RAC review sheds light on improper claims reported during global periods. Think you know how to use modifiers correctly to collect for both an evaluation and management (E/M) visit and a procedure? If you're not keeping a close eye on the procedures' global periods, you might want to think again. That's the word from Performant Recovery, an approved recovery audit contractor (RAC), who announced in January that it will be scrutinizing claims that violate Centers for Medicare and Medicaid (CMS) guidelines for E/M codes billed with procedures that have 0-, 10- and 90-day global periods. So, before you risk...

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