Part B Insider (Multispecialty) Coding Alert
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• Modifier misuse allegations might be partly responsible for one physician's legal troubles. A New Jersey practice allegedly overbilled Medicare by almost $5 million by fraudulently reporting lymphedema procedures to its carrier.Although the practice billed for surgery that the physician personally performed, investigators charged that unsupervised physical therapists, licensed practical nurses, and massage therapists were performing physical therapy services on the patients rather than surgeries. The attorneys allege that the physician certified that the services were medically necessary, and used inappropriate modifiers and CPT codes to report multiple procedures within a short time period, according to a July 14 press release from the N.J. Office of the Attorney General. To read the complete press release, visit www.nj.gov/oag/newsreleases09/pr20090714b.html.
Part B Insider (Multispecialty) Coding Alert
- COPAYMENTS:
Don't Write Off Low-Income Copays Until You Get the Facts
Use all of your state's resources for assistance. If your practice sees a lot of [...] - NEUROLOGY:
Count Separate Nerves If Coding Neuromuscular Junction Tests
Counting nerves correctly leads to fewer repays. Even though your physician may --and often will -- [...] - REIMBURSEMENT:
5 Coding Opportunities You May Have Overlooked
You could be turning away your rightful reimbursement for scores of services. Medicare coding rules [...] - MODIFIERS:
Don't Get Burned by Bilateral Modifier Guidelines
Number '2' in column Z? Strike out modifiers 50, RT, LT as options. Not sure [...] - READER QUESTION:
Before Using Repair Code, Check for These Essential Items
Hint: Steri strips won't allow you to qualify for the 12001 series -- look to the [...] - PART B CODING COACH:
Bilateral Cochlear Implants Create Programming Code Dilemma
Professional associations go to bat for audiology coders. If your physician performs cochlear implants, you're [...] - PHYSICIAN NOTES:
Hospital Readmissions Continue to Remain a Priority for CMS
Plus: N.J. Attorney General charges one practice with billing surgeries when in actuality, they allege [...] - In other news ...
• Modifier misuse allegations might be partly responsible for one physician's legal troubles. A New [...]