tci Medicare Compliance & Reimbursement - 2018 Issue 13

Part B Statistics: Measure Your Critical Care Numbers Against Other Providers'

See whether your E/M claims are on track. Medical necessity determines whether a service falls under the guise of critical care. However, due to confusion over CMS’s criteria for the use of the E/M codes, critical care remains a perennial favorite on Medicare claims auditors’ checklists. A new Comparative Billing Report (CBR) from Palmetto GBA showcases the national statistics on critical care services to help you figure out how your claims stack up against your peers’. Details: In its CBR published May 7, Part B MAC Palmetto GBA looked at unusual trends and billing issues that the payer...

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