tci Medicare Compliance & Reimbursement - 2020 Issue Q1

Compliance: E/M Services Remain Perennial Problems for Providers

Initial hospital care, office visits top improper payment charts. It’s no surprise that practices struggle with properly documenting and coding E/M services. After all, these popular codes are the foundation of many providers’ Medicare pay. But some codes pose more of a challenge than others, and the latest Comprehensive Error Rate Testing (CERT) numbers may come as a shock. Background: In coordination with the CERT program, the Centers for Medicare & Medicaid Services (CMS) recently issued the report, “2019 Medicare Fee-for-Service Supplemental Improper Payment Data.” The brief highlights the most prevalent errors in the different parts...

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