tci Medicare Compliance & Reimbursement - 2006 Issue 25

Enforcement: Report And Request Aren't Enough For Consults Without Medical Necessity

Use of modifier 25 exposes that doctor knew he flouted the rules.If you're worried about running into trouble for your consult billing, then a recent case could be an important bellwether. A False Claims Act case against a Las Vegas critical care doctor can go to trial the U.S. District Court in Nevad Use of modifier 25 reveals that doctor knew he flouted the rules If you're worried about running into trouble for your consult billing, then a recent case could be an important bellwether. A False Claims Act case against a Las Vegas critical care doctor...

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