Medicare Compliance & Reimbursement

Physicians documented their subsequent hospital care poorly. If you often rely on 99211, beware. A new CMS report reveals that more than 15 percent of claims submitted to Part B for this code between Sept. 2006 and Sept. 2007 were missing critical documentation, causing Medicare to request more than $24 million back from providers. The comprehensive error rate testing (CERT) report found 99211 billed inappropriately in the "insufficient documentation" category. Meanwhile, the CMS report indicates that Medicare paid out nearly $39 million more than it should have for subsequent hospital care code 99232 in the "no documentation" error category. "It's possible that doctors in the hospital tend to peek in on the patient and don't write a lot in the chart," notes Barbara J.Cobuzzi, MBA, CPC,CPC-H, CPC-P, CENTC, CHCC, senior coder and auditor for The Coding Network and president of CRN Healthcare Solutions. "The physician may write, 'Patient stable,' or [...]