Billing

The Centers for Medicare & Medicaid Services has published its latest Medicare Quarterly Provider Compliance Newsletter, which provides guidance to address medical billing errors.

The newsletter is designed to identify common billing errors and other erroneous activities when dealing with the Medicare Fee-For- Service (FFS) Program.

Topics discussed in the October 2016 issue include the following:

  • Transluminal Balloon Angioplasty, Venous
  • Endovenous Ablation Therapy of Incompetent Vein
  • Blepharoplasty
  • Transurethral Resection of the Prostate

CMS provides background on the procedure, the cause(s) of the most improper payments, examples of how providers fail to bill properly, recommendations on how healthcare professionals can avoid improper payments and resources.

To access the October 2016 issue, click here.

The Centers for Medicare & Medicaid Services (CMS) has issued a reminder to providers concerning billing the correct level of service for evaluation and management (E/M).

CMS notes that a 2012 study report from the Office of the Inspector General indicated that a number of physicians increased their billing of higher level, more complex and expensive E/M codes. Many providers submit claims coded at a higher or lower level than the medical record documentation supports.

CMS advises providers to use the following resources to assist in their efforts to bill correctly for E/M services:

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