BC Advantage - 2020 Issue 3

Single-Center Study Raises Larger Issues about Proper Billing

Two CMS codes for advanced care planning - 99497 and 99498 - were used less than 20 times at a tertiary care center in Iowa in a nearly 3-year period, according to findings published in the Journal of the American Board of Family Medicine. Additionally, the center was successfully reimbursed only about one-quarter of the time, potentially resulting in lost revenues. Billing errors are not limited to advanced care planning, and the findings from the single-center study speak to larger issues about reimbursement, according to Frank Campbell, MHA, MBA, former chief strategic and business planning officer at the...

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