Medicare Compliance & Reimbursement

When RACs find massive errors, MACs listen. Starting this July, modifiers will be more important than ever for E/M services you perform during surgical global periods. That's because CMS is taking a cue from the recovery audit contractors (RACs) and will soon be putting edits on your claims for these services to reduce improper payments. According to two separate CMS transmittals (1051 and 1052, both updated recently), CMS reviewed the issues that RACs identified as the sources of "significant improper payments" and the agency hopes that new edits will cut down on these problems. CMS highlighted the following topics as targets of the upcoming edits, which you'll begin to see in action this summer. 1. E/M Services Performed During the Global Period. Medicare includes most E/M services performed during the global period of surgical services with global days of 000, 010, and 090 in the surgical payment. MACs will be [...]