Part B Insider (Multispecialty) Coding Alert
In other news
Coding urine drug testing seems pretty straightforward—but for one laboratory, reporting these services landed them in hot water with the government, and cost them a $4.675 million settlement.
The lab billed Medicare and Medicaid over a four-year period for urine drug testing, and added pathology codes along with the standard CPT codes to increase its charges. The lab performed a medical review (which Medicare doesn’t cover) with each urine drug screen and tacked on the pathology code for these services, the OIG said in a statement.
It’s possible that the settlement could lead to increased scrutiny of laboratory services, if the OIG’s report is any indication. “
“Medicare is the largest payer for clinical laboratory services and, therefore, is vulnerable to fraud, waste, and abuse,” said Gloria Jarmon, Deputy Inspector General for Audit Services in the May 21 news release. “In addressing that vulnerability, HHS-OIG uses a multidisciplinary approach, including data-mining, audits, and, as appropriate, enforcement actions, to protect the integrity of HHS programs and recover taxpayer dollars.”
To read the complete news release about the settlement, visit www.justice.gov/usao/wvs/press_releases/May2014/attachments/0521141_Calloway_Settlement.html.
Part B Insider (Multispecialty) Coding Alert
- Nursing Facility Visits:
This Payer Is Scrutinizing Nursing Facility Visits Carefully
Codes 99309-99310 are under the microscope for NGS Medicare practices. If you think CMS is [...] - Compliance:
OIG Considers Expanding Civil Monetary Penalties
You could be subject to penalties for five additional reasons if the proposal is finalized. [...] - Supervision:
Keep Track of Where Your Doctors Are When Your Ancillary Staff Performs Service
Otherwise, you could be violating supervision requirements. Like many practices, you are likely trying to [...] - Reader Question:
Historical Review May Not Be Billable
Question: A patient had her past medical records, containing more than 10 years of history, [...] - Reader Question:
Determine When Flu Vaccine, E/M Are Both Payable
Question: I have been reporting the flu vaccine with E/M visits and other in-office procedures. I [...] - Reader Question:
Know What 'Split Night' Entails
Question: I’ve been hearing the term “split-night service” lately but don’t know what it is. Can [...] - Part B Coding Coach:
Ace Tumor Ablation Coding With This Expert Advice
Hint: Watch for CCI bundling for multiple procedures involving other tumor removal methods. When your [...] - Physician Notes:
'Two Midnight' Rule Needs Revision, OIG Says
Plus: Billing extra codes for urine testing cost this lab over $4.6 million. It hasn’t [...] - In other news
Coding urine drug testing seems pretty straightforward—but for one laboratory, reporting these services landed them [...]
