tci Medicare Compliance & Reimbursement - 2004 Issue 27

PHYSICIANS: Doctors Could Be Throwing $1,400 Away

Downcoding just two E/M visits a week can cost an arm and a leg. It may not seem like a big deal to bill a 99212 instead of a 99213 occasionally for evaluation and management visits. But those little reductions can add up. Let's say a three-physician practice downcodes from a level three to a level two office visit twice a week per physician. That's just six downcodings from 99213 to 99212 per week. Assuming a 48-week year, that adds up to $1,434 per year, according to consultant Mary LeGrand with Karen Zupko & Associates in Chicago."It...

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