tci Part B Insider - 2010 Issue 17

PART B AUDITS: Auditors Review Your Notes Based on the Regs As of the Service Date

If you performed a consult in 2006, the auditor will use 2006 guidelines -- not today's rules. Most Part B practices have grown accustomed to tucking consult regulations into the backs of their minds, since Medicare no longer pays for these services. However, if an auditor comes calling and wants to review your consult notes, he will be judging you based on the Medicare rules as of the date of service. Some practices assume that any audits taking place in 2010 or thereafter that involve consult notes will be based on CPT consult rules, and not Medicare's, since Medicare...

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