Auditing/Compliance Tips & Resources

 

Need to Know: You have 60 Days to Refund Gov't Overpayments

The Patient Protection and Affordable Care Act of 2010 (ACA) requires healthcare providers to return overpayments to government payers, with an explanation of why the payment is being returned, within 60 days from the time that the provider identifies the overpayment ...

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Coding for Biopsy with a Related, More Extensive Procedure

Although you may not separately report (or receive reimbursement for) a biopsy following a more extensive procedure, such as an excision, at the same anatomic location and patient encounter, you may report the biopsy separately if it precedes and leads to the more extensive procedure

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Treating Complications for Medicare Patients

Medicare rules for treating complications during the postoperative period differ from CPT® guidelines. Specifically, to separately report treatment of complications to Medicare payers, that treatment must meet one of two conditions ...

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