Study Identifies Common Medicare Billing Issues

CMS has released results from its recent study on common billing mistakes by health care providers. Among the most common mistakes include unbundling – the practice of submitting claims by piecemeal to maximize reimbursements for tests and procedures that are required to be submitted together at a reduced cost.  Other common mistakes are using the wrong diagnosis code to support an MRI and coding a subsequent Annual Wellness Visit improperly as an initial wellness visit.

 The study also revealed that common forms of underbilling include coding for the wrong surgery and using a lower level of Evaluation and Management than the documentation supports.

More information on the study can be found at: Comprehensive Error Rate Testing (CERT).

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