tci Medicare Compliance & Reimbursement - 2007 Issue 45

Claims Accuracy: Healthcare Practices Threw Away $259 Million Last Year

ASCs boast low error rates; general practices show the highest If the latest CERT report is any indication, you could have made a lot more money last year. According to the Comprehensive Error Rate Testing (CERT) results that the Centers for Medicare & Medicaid Services (CMS) released in late November, Medicare carriers discovered more than $259 million in undercoding billing errors, which means that medical practices shorted themselves that much last year. For example, the report highlights a practice that billed 40 units of J1756 (Iron sucrose, 1 mg). CMS discovered, however, that the practice actually injected 200 mg...

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