REIMBURSEMENT:
Cover Cardiology E&M Coding Bases With 5 Smart Compliance Moves
Published on Thu Jan 28, 2010
Check out this succinct 'million dollar statement' to cinch documentation requirements. Are your cardiology or specialty practice's evaluation and management services garnering fair Medicare payment -- or are they a ticket to potential reimbursement recoupments and worse? The answer can lie in the details that both keep the cash flowing and your compliance record on the high road. A costly assumption: "Some cardiologists will assume that they have sicker patients and can bill higher level E/M codes ...," says Leatrice Ford, RN, founder of ConsultCare Partners in Louisville, Ky. "But a family practice physician managing a cardiac failure patient in and out of the hospital will potentially have sicker patients, as the patient usually has other issues, such as renal impairment and diabetes." "If a physician is consistently coding level 5s, that will trigger the MAC to take a look," counsels Sandy Fuller, CPC, MCS-P, HIS supervisor and compliance officer for [...]