Part B Insider (Multispecialty) Coding Alert
HIGH-END BILLING PUTS YOUR MEDICAL RECORDS ON THE LINE
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Feds see through alleged cover-up at KY clinic If your billing patterns stick out from the norm, you could end up as the centerpiece in a federal investigation. Case in point: The government filed a false claims complaint April 30 against Logan Pain Management Center, Inc and anesthesiologist/clinic operator Dr. Michael Stevens, according to U.S. Attorney David L. Huber. From 1997 to 2003, Stevens allegedly billed Medicare $1.9 million for only 99 patient treatments, and Medicaid $1.5 million for only 45 patients. The complaint charges that service claims, such as those for neuromuscular junction tests, overstated by several hours the amount of time Stevens actually treated patients. Also, the complaint alleges Stevens never performed some services. The investigation turned into a family affair when Steven's wife and in-laws, who also worked for the clinic and provided billing services, were named in the complaint for allegedly altering patient files, at Steven's request, to support the fraudulent claims.
Part B Insider (Multispecialty) Coding Alert
- EVALUATION & MANAGEMENT:
No E/M Coding Changes Until 2006
Clinical examples are too subjective to please CMS auditors Don't throw away your calculator yet. [...] - PRESCRIPTIONS:
Beware Of Compliance Hurdles In Brave New E-Scrip World
The Medicare Modernization Act calls for the Centers for Medicare & Medicaid Services to encourage [...] - BEWARE OUT-OF-STATE PRESCRIPTIONS
Beware of writing a prescription for a patient living in another state, especially if you're [...] - DIAGNOSIS CODES:
Use New Decubitus Ulcer ICD-9 Codes For 15999 Claims
At last,a way to explain ulcers that aren't bed sores Billing for excision of decubitus [...] - HIGH-END BILLING PUTS YOUR MEDICAL RECORDS ON THE LINE
Feds see through alleged cover-up at KY clinic If your billing patterns stick out from [...] - MODIFIERS:
Don't Throw Away E/M Reimbursement On Last-Minute Decisions
Follow these guidelines to get paid for -57 modifier Surgeons are throwing away reimbursement for [...] - Steer Clear Of Keeping Payers In The Dark
Biller faces fraud charges for allegedly skewing the facts on claims Fraud fighters keep cracking [...] - MODIFIERS:
Consider Using Time-Based Billing For E/M Visits With Modifier -57
Remember the 50-percent rule and you'll come out ahead. An evaluation and management visit in [...] - Part B Coding Coach:
Want To Make $43 More Per E/M Visit?
4 steps help you avoid unnecessary downcoding If you underestimate your physician's medical decision-making, you [...] - PHYSICIAN NOTES:
Non-Compliant CMNs Place You At Risk
Latest physician-supplier scam allegedly billed Medicare $3.7 million Before you sign a certificate of medical [...]