Medicare Compliance & Reimbursement

Save yourself from this potential minefield with these expert tips.If you see a patient in the hospital prior to his surgery, you typically can't count that toward reporting an E/M service -- instead, your pre-procedure check-in with the patient will be included in payment for the service you perform.Some hospitals, however, aren't aware of this rule -- and the OIG is watching. A recent audit of Georgetown University Hospital in Washington, DC revealed that 21 of 125 selected claims showed errors related to outpatient E/M codes being billed with other services.The E/M services "were not separately payable because they were part of the usual preoperative and postoperative care associated with a procedure and paid as part of that procedure," the OIG's April 3 audit report said. "Hospital officials stated that these errors occurred because billing documents were improperly sorted during the hospital's transition from paper to electronic medical records. As a result, [...]