The Medicare Improper Payment Report does not measure fraud, but rather, it estimates the payments that did not meet Medicare coverage, coding, and billing rules. The estimated Medicare FFS payment accuracy rate (claims paid correctly) from July 1, 2019 through June 30, 2020, was 93.74%, which is up slightly from last year. The estimated improper payment rate (claims paid incorrectly) was . . .
What if my Medicare patient refuses to fill out the outcome assessment questionnaire?
Inform the patient that Medicare requires that you demonstrate functional improvement in order for them to determine if the care is medically necessary. In other words, they may have to pay for the care out of pocket if …
Question: If orthopedic tests are negative, do you need to still list them in your treatment notes?
Answer: Yes. Any tests which are performed by a healthcare provider, regardless of the result, should be documented in the patient record. This record is the only way that a reviewer or another provider …
In order to understand and answer the question, “Why code 99080 is being denied when billed with an E/M Service, it is important to first review the requriements of selecting the appropriate level of Evaluation and Management service and how that relates to reporting a 99080 special report service. Continue reading for better understanding.
Q: An insurer told me that chiropractors cannot bill 99204 or 99214 because those exams “require a level of decision making that would typically only occur in an emergency room.” Is this true? Do I have any recourse?
In this webinar, Dr. Gwilliam will review chapter 4.2 Common Procedure Codes. More than half the chapter is brand new for 2016 and it is crammed full of coding and documentation tips for the codes you use most. Figure out all the little tricks you need to keep your claims clean and survive an audit. Bring your copy of your DeskBook to follow along.