tci ED Coding & Reimbursement Alert - 2020 Issue Q1

Compliance: Have You Built an Audit Plan? Payers Are Expecting It

Hint: Medicare isn’t the only payer reviewing records for errors. No matter how diligent you’ve been about your CPT® code assignments, you could still be at risk of an auditor’s scrutiny. Payers are looking at a wide range of issues, from modifier use to code frequency, and your coding trends might make you a target. That was the word from Frank Cohen, director of analytics and business intelligence at Doctors Management, during his Jan. 16 presentation, “Risk-based Auditing: New Tools and Techniques.” He outlined this and other issues that medical practices might face in...

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