tci Medicare Compliance & Reimbursement - 2014 Issue 5

Part B Coding: Get Official Guidance on These Tricky Compliance Issues

Tip: Knowing what not to do can make all the difference. Don’t depend on hearsay when it comes to coding and billing compliance. Find out what Medicare’s official guidelines are for five common, yet vexing, issues. Examine 3-Year Rule Question 1: We submitted a claim for our doctor but it was denied with the error note, “This patient was seen by your group within the last three years” but this doctor never saw the patient before. What did I do wrong? Answer: Most likely, someone else in your practice saw the patient within the last three...

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