Part B Insider (Multispecialty) Coding Alert
Physicians Still Rank High on List of Fraudsters
Plus: New CMS provider call could shed light on billing therapy services. The percentage of medical practices that were found or pled guilty to Medicare fraud charges is still fairly high, a new report indicates. In an analysis of Department of Justice and OIG data from 2010, the Government Accountability Office found that 43 medical practices were found or pled guilty or no contest to healthcare fraud, while another 130 medical centers/clinics fell into that category. Combined, these medical facilities make up 18.7 percent of the total number of subjects found or pled guilty or no contest--which is the highest percentage among all provider types. Coming in a close second were the 171 durable medical equipment suppliers that were found or pled guilty, the GAO says. This category made up 18.5 percent of total guilty subjects. The report is online at www.gao.gov/assets/660/650341.pdf.
Part B Insider (Multispecialty) Coding Alert
- Compliance:
OIG Revisits Recommendation to Adjust Global Surgery Fees Based on E/M Services
OIG discovered inconsistent billing for global surgery and believes adjustments could save CMS over $97 [...] - Billing:
Locum Tenens Billing Doesn't Apply to New Docs Who Aren't Yet Credentialed
Uncredentialed physicians don't fall into any 'locum tenens loophole.' Myth: Tired of waiting for your [...] - Clip And Save:
13 Tips for Recouping Payment for Substitute Physicians
Hint: Don't mix up modifiers Q5 and Q6. Although you can't bill locum tenens for new [...] - 2013 AMA Symposium Update:
Get the Scoop on CPT's All-New Transition Codes
Caution: Missing primary care designation could wreck your Medicare pay. Primary care physicians, take note: [...] - Part B Coding Coach:
HCPCS Q2048 or J9002 in 2013? Doxil Coding Changes Again in the New Year
Plus: See what's different for Erwinaze, Adcetris, mitomycin, and more. Other specialties may be reeling [...] - Physician Note:
Physicians Still Rank High on List of Fraudsters
Plus: New CMS provider call could shed light on billing therapy services. The percentage of [...] - In other news
Want to get up-to-speed on therapy functional reporting? CMS is holding a National Provider Call [...] - Reader Question:
Drain Removal Could Warrant Modifier
Question: Surgeon A performed a posterolateral fusion, laminectomy, and pedicle screw insertion. Then two days [...] - Reader Question:
Some Symptoms Inherent in Diagnoses
Question: Can I report the diagnosis codes for tonsillitis, pharyngitis and upper respiratory infection together? [...] - Reader Question:
State Laws Dictate Who the Doc Can Supervise
Question: Can a physician bill as a supervising provider when the staff member (in our [...]
