Medicare Compliance & Reimbursement

Avoid these upcoding mistakes. Do you recognize when your physician documents a 99214 but only circles a CPT 99213 on the superbill? If you don't, then your practice could be losing money. Every year when CMS releases its benchmarking data, code 99213 (Office or other outpatient visit...) ranks number one as the top-billed code by medical practices. But just because you're billing it frequently doesn't mean you're billing code 99213 correctly. Check out these three quick tips to determine whether your 99213 coding could use a tune-up. Tip 1: Get an Auditing Tool Some practices say that they report 99213 often because in some situations they "think" the doctor has documented enough to warrant 99214, but they aren't sure so they bill 99213 to be safe. Solution: If the coders are assigning the levels of service, they should be using an auditing tool. There are many auditing tools available, including [...]