decisionhealth Newsletters, Part B News - 2019 Issue 2 (February)
Watch out for CMS’ claims reviews on high-price radiation oncology services
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Article Overview
This article explains why CMS is reviewing billing patterns in radiation oncology and how Comparative Billing Reports are being used to flag services associated with higher-than-average utilization. It is aimed at billing, coding, and compliance staff in radiation oncology practices who need to understand the general scope of Medicare review activity, the service categories being watched, and the broader compliance issues raised by recent reporting trends.
Why This Topic Matters
The piece helps readers recognize when Medicare billing patterns in radiation oncology may draw attention from claims review activity. It is relevant for practices seeking to evaluate compliance risk in IMRT-related reporting and to understand why CMS is focusing on certain high-dollar services.
What You Will Learn
- How CMS uses Comparative Billing Reports to review billing patterns
- Why radiation oncology services are receiving attention in Medicare claims review activity
- What broad compliance issues practices should consider when reviewing IMRT billing
- How utilization trends can affect audit risk awareness
- Why radiation oncology billing staff should reassess claim patterns and reporting practices
Who Should Read This
- Radiation oncology coders
- Billing staff
- Compliance officers
- Practice managers
- Medicare providers
Codes Discussed
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