tci Outpatient Facility Coding Alert - 2017 Issue 11

Coding: Replacing Medical Devices at No Cost? Report 'FD' Plus Condition Code 40 or 50

Failing to correctly report value and condition codes led to overpayments of $2.7 million in 2016. Providers: When Medicare issues a reminder, it's time to listen. And that's just what they did in October's issue of MLN Connects, CMS' weekly newsletter from the Medicare Learning Network. Around this time last year, the OIG published audit results regarding a review of outpatient claims for replaced cochlear devices. Of the 149 claims reviewed, 116 were found to contain coding errors that resulted in overpayments of $2,685,588. On those claims, which listed no-cost cochlear device replacements, coders failed to...

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