Part B Insider (Multispecialty) Coding Alert
Consults, NPP Billing Lead To Big Payouts
Three physicians agreed to repay $1 million after they allegedly billed for services that nurse practitioners and physician assistants provided. The physicians billed for the services as though they provided them personally.
Also, a Pennsylvania cardiologist repaid $435,000 after the government claimed he was billing consults that didn't meet the definition of a consult, or lacked proper documentation. The feds also claimed he billed for evaluation & management services that were already covered in his payment for nuclear stress testing.
Beware: Those are just two of the horror stories in the latest semiannual report from the HHS Office of Inspector General. The OIG is still looking over your shoulder on incident-to billing, consults and incorrect place of service (POS).
Just ask the Ohio pain management physician who received a life prison sentence, plus $14.3 million repayment, after a jury found he performed unnecessary--and painful--procedures on patients, in exchange for narcotic prescriptions.
Part B Insider (Multispecialty) Coding Alert
- PART B MYTHBUSTERS:
You Can Only Bill Fracture Code Once
Don't attract carrier scrutiny with the wrong diagnosis code
Myth: A patient with a bone fracture [...] - NPIs:
At Last You Can Look Up Other Doctors' NPIs
Don't leave your doctor's home address in the database
Any day now you can download a [...] - Path/Lab Codes Hit With More CCI Edits
The Correct Coding Initiative version 13.2 is probing molecular-probe codes deeply.
A number of pathology and [...] - PART B MYTHBUSTER:
Don't Miss Out On Extra Diabetes Reimbursement
Think you can't bill Medicare for 2 screenings per year? Think again!
Fact: The U.S. spends [...] - CCI 13.2:
Watch Your Laparoscopy Coding On The Same Day As Surgery
No modifier will save you from new digestive surgery edits
The latest version of the Correct Coding [...] - CCI Grants Relief From Spinal Surgery Edits
CPT 2006 gave you some new codes for kyphoplasty and percutaneous vertebroplasty, and then Correct [...] - COMPLIANCE:
Don't Raise Suspicions With Hospital Buyout
If your doctors want out, they can't profit from their clout
If your doctor wants to [...] - Consults, NPP Billing Lead To Big Payouts
Three physicians agreed to repay $1 million after they allegedly billed for services that nurse [...] - Part B Coding Coach:
Flu Test Status Got You Stumped? Follow This Expert Advice
If you always reach for 87804, you could be mis-coding
When your family physician tests a [...] - New Cardiac Arrest Codes Coming In Latest ICD-9
In the fall, ED coders will have some new ICD-9 codes to get used to, [...] - PHYSICIAN NOTES:
Dip Into CMS' 'Tool Kit' To Fine-Tune Your PQRI Planning
Anti-trust actions could stop your collaborations in their tracks
Need help with the P's and Q's [...]
