tci Part B Insider - 2016 Issue 9

Observation Care: Don't Make this $259 Observation Coding Mistake

WPS Medicare outlines exactly why one provider’s documentation didn’t pass muster. You may save a few minutes at the hospital by skimping on documentation so you can move onto the next patient, but you’ll hurt yourself in the end when your MAC requests repayments due to insufficient medical records. Don’t believe it? Consider this example that Part B payer WPS Medicare recently reported among its Comprehensive Error Rate Testing (CERT) issues. Example: A provider billed 99220 (Initial observation care) for date of service Oct. 23 and CPT® 99217 (Observation care discharge day management) on Oct...

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