tci Part B Insider - 2014 Issue 14

Part B Coding Coach: Don't Let Improper Time Documentation Ruin Your Claims

Replace Outpatient E/M codes with a single G code for Medicare PHP claims. According to the latest Comprehensive Error Rate Testing (CERT) results, improper documentation of time has been leading to overpayments, especially for claims involving psychotherapy with E/M codes. The report released in an MLN Matters article dated March 18th revealed that “the main error that CERT has identified with the revised psychiatry and psychotherapy codes is not clearly documenting the amount of time spent only on psychotherapy services.” The problem area: The article identifies that many coders have not been documenting time spent on &ldquo...

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