Medicare Compliance & Reimbursement

Feds find that suppliers shortchange themselves on standard wheelchairs. You could be losing $977 per K0823 claim if you're not coding correctly, according to a new HHS Office of Inspector General report. That's how much suppliers who downcoded standard wheelchair claims lost on average, the OIG says in the study, "Miscoded Claims for Power Wheelchairs in the Medicare Program." In the first half of 2007, wheelchair suppliers miscoded 8 percent of power wheelchair claims overall, the OIG found. About 3 percent were up-coded, 4 percent were downcoded, and OIG reviewers couldn't determine a coding level for 1 percent. Three-fourths of power wheelchair claims under Medicare fall into the K0823 category, the OIG explains. In 2007, they had a fee schedule amount of $4,024. Suppliers furnishing standard chairs shortchanged themselves more with downcoding -- $977 on average -- than they gained with upcoding -- $437 on average. But that changed when suppliers miscoded complex [...]