tci Medicare Compliance & Reimbursement - 2007 Issue 8

E/M CODING ~ Medicare Overspends Millions On Upcoded Inpatient Visits -- What You Need To Do

7 tips to keep your inpatient E/M coding on the up-and-up. The carriers are scrutinizing your inpatient hospital visits more than ever. Will you be ready?Problems: Medicare overspent  $112 million on claims for subsequent hospital visit code 99233 and $41 million on 99232, according to the Nov. 2006 Comprehensive Error Rate Testing report. In both cases, visits were upcoded by one level, claims the Centers for Medicare & Medicaid Services (CMS).Also, Medicare overspent $57 million on upcoded claims for initial inpatient consult code 99254. And CMS says upcoded claims for initial inpatient visit code 99222 cost the...

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