Part B Insider (Multispecialty) Coding Alert
CMS Rolls Out New Medicare Advantage Auditing Plan
Plus: Dallas Physician Arrested As Part of $375 Million Scheme. CMS has been auditing Medicare Advantage (MA) plans since 2008, so practices may not be surprised to hear that those audits are still taking place. What is new, however, is the fact that CMS recently instituted a new initiative to slash errors in the MA program. By tweaking the audit methodology in a new way, CMS hopes to recover an estimated $370 million in overpayments. "Fighting fraud, improving payment accuracy, and saving money for Medicare is one of our top priorities," said CMS Acting Administrator Marilyn Tavenner in a Feb. 24 statement. "CMS will use a new method of auditing Medicare Advantage plans that improves program integrity and reflects public input." To read more about how CMS intends to calculate the results, visit http://www.cms.gov/Plan-Payment/02_PaymentValidation.asp.
Part B Insider (Multispecialty) Coding Alert
- Billing:
At Long Last, CMS Agrees to Allow E-Signatures on PECOS Applications
Plus: Avoid adding discharge date to 5010 claims for outpatient services. Ever since CMS began [...] - Part B Revenue Booster:
5 Strategies Lead You to 99211 Success
Hint: Don't use level 1 visit for all vaccinations and allergy shots. Many physician coders [...] - Modifiers:
Master These 3 Modifier 25 Issues to Get Claims Paid
Hint: Modifier 25 may apply to E/M performed with xxx global-day procedures.Want to collect for [...] - Modifier 25:
Conditions for Use
When appending modifier 25, the E/M service must meet these requirements:The E/M is significant and [...] - Compliance:
Your Staffers Will Be Less Likely to Whistle If You Follow These Tips
A robust reporting mechanism is your best defense against a whistleblower suit.If your compliance plan [...] - Follow OIG Compliance Plan Guidance Step By Step
Missing an element could set you up for a costly lawsuit, or worse.Don't get caught [...] - Part B Coding Coach:
Avoid These Hot Spots When Coding Burn Care
Hint: Anesthesia coders follow the same tactic as surgical coders. Coding for burns that affect [...] - Physician Note:
CMS Rolls Out New Medicare Advantage Auditing Plan
Plus: Dallas Physician Arrested As Part of $375 Million Scheme.CMS has been auditing Medicare Advantage [...] - In other news
Most medical practices are lucky to see $375 million in the course of several decades--but [...] - Reader Question:
Not All Drug Wastage Is Billable
Question: How should I bill for wasted drug? Our physician often splits a single vial [...]
