tci Medicare Compliance & Reimbursement - 2008 Issue 29

Reader Question: Don't Let Billers Add Services To Claims Without Permission

Only report what shows on the encounter superbill. Question: Our office uses an outside biller. In reviewing some of the EOBs, I've found instances when the biller is adding services that the physician hasn't marked on the superbills. For example, a patient came in for a follow-up appointment (99213) and she received an injection of Toradol (J1885). The biller added 90772 to the claim as well. Is it OK for her to do this? Answer: Stick to the adage, "If it's not in the documentation, you cannot bill it." When billing, you should never add codes for services...

To read the full article, sign in and subscribe to tci Medicare Compliance & Reimbursement.


Keep pace with evolving Medicare regulations — and onboard your team — with timely analysis of critical updates interpreted in an easy-to-follow, easy-to-apply format. Your subscription to TCI's Medicare Compliance & Reimbursement Alert will equip you to navigate code and guideline changes, CCI edits, and revisions to modifiers, payer policies, the fee schedule, OIG target areas, and more.

  • Current newsletters added each month
  • Fully searchable archives - over 4200 articles
  • ALL years/issues back to 2003 organized by year and issue
  • Codes mentioned in articles are linked to Code Information pages
  • Code Information pages link back to related articles
Access to this feature is available in the following products:
  • tci Medicare Compliance & Reimbursement +Archives

demo
request yours today
 subscribe
start today
 newsletter
free subscription

Thank you for choosing Find-A-Code, please Sign In to remove ads.