Part B Insider (Multispecialty) Coding Alert
Statistical Sampling:
Carriers Have More Leeway To Use Smaller Sample Sizes
Published on Tue Mar 02, 2004
One reason why carriers don't always play it safe with overpayments: the standards are lax for the use of statistical sampling, says attorney Craig H. Smith with Hogan & Hartson in Miami.
It used to be that carriers had a strict standard, in an appendix to the Medicare Carriers Manual, for the number of claims they had to audit before they could perform a statistical sample and extrapolate to all other claims, notes Smith. But in Program Memo B-01-01, issued January 2001, Medicare threw out that standard and replaced it with vague instructions saying that the size of the sample "will have a direct bearing" on the accuracy of the overpayment "but it is not the only factor that influences precision."
Other Articles in this issue of
Part B Insider (Multispecialty) Coding Alert
- Appeals:
They Can't Collect Until They Make Their Case
But will carriers let your appeals keep running up the flagpole?
In the past, the carriers [...] - Modifiers:
When 2 Surgeons Collaborate, Make Sure To Communicate
How to handle fear of the -62 modifier
It strikes terror into physicians' hearts and slashes [...] - Statistical Sampling:
Carriers Have More Leeway To Use Smaller Sample Sizes
One reason why carriers don't always play it safe with overpayments: the standards are lax [...] - Transmittals:
Prepare To Lose RVUs When You Perform
Multiple cystourethroscopy procedures receive massive pay cut
Once again, the Centers for Medicare & Medicaid Services [...] - Eye Exam Codes Raised
Transmittal 45 from the Centers for Medicare & Medicaid Services includes pay boosts for six [...] - Unlisted Codes:
Use 22899 For Kyphoplasty, But Make Your Case For Extra Pay
Boost your reimbursement by scanning carrier policies
Often, many of the fastest-growing procedures are the ones [...] - LEGISLATION:
Chances of Medicare Reform Bill Limited
Some are predicting that 2004 will see yet another giant Medicare bill, partly aimed at [...] - Coding & Reimbursement:
Reassignment Of Benefits Will Become Possible Soon
Use per-diem codes for ESRD services if patient is hospitalized during month
[...] - PART B CODING COACH:
2004 ICD-9 Update: Use New V Codes For All Your Insulin Pump Visits
If your physician is using insulin pumps for Type I diabetics, you should know how [...] - Physician Notes:
Non-Compete Keeps Physician From Setting Up Office Across The Street
Court rules that doctor can't work within 25 miles of old stomping ground
If you're hiring [...]
View All
