Thursday, October 19, 2017

Bill it Right the First Time 10/19/2017



Bill it Right the First Time


19 October 2017

This blog is designed to provide education on how to avoid common billing errors and other erroneous activities when dealing with the Medicare Fee-For-Service (FFS) Program and/or other carriers.

Provider Types Affected: Physicians

Background: The rotator cuff is a frequent location of shoulder pain which can result in weakness and shoulder instability. Arthroscopic rotator cuff repair is a procedure to repair tears of the rotator cuff. Description of Special Study:

The CERT review contractor conducted a special study of claims with lines for arthroscopic rotator cuff repair procedures billed with Healthcare Common Procedure Coding System (HCPCS) code 29827 (arthroscopy, shoulder, surgical; with rotator cuff repair) submitted from January through March 2016.

Finding: Insufficient Documentation Causes Most Improper Payments Most improper payments for HCPCS code 29827 in this special study were due to insufficient documentation errors. Insufficient documentation means something was missing from the medical records. For example, claims with insufficient documentation lacked one or more of:

• Supporting documentation for the medical necessity of the procedure
• Procedure note
• Physician’s signature, or signature attestation, on a procedure note or diagnostic report


The CERT review also concluded on other services for the same period:

Improper Payments due to Insufficient Documentation - Missing documentation to support medical necessity

Sample of Claims Reviwed:

#1

The submitted records were missing the provider’s order for the B-12 injection and documentation supporting the medical necessity of the medication. The CERT review contractor scored this claim as an insufficient documentation error and the MAC recovered the payment from the provider


#2

A provider billed an APC payment line for HCPCS code 96372 (Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular) with APC code 00437 (Level II Drug Administration). The service of HCPCS code J3420 (Vitamin B-12 injection) was a packaged service under APC code 00437. The provider submitted the following:

• Medication administration record

And additional request for documentation returned no documentation.

The submitted records were missing the provider’s order for the B-12 injection and documentation supporting the medical necessity of the medication. The CERT review contractor scored this claim as an insufficient documentation error and the MAC recovered the payment from the provider.


Providers and/or Suppliers are encouraged to be familiar with the details of Medicare Coverage Policy , Medicaid Coverage Policy and Commercial Health Insurance Coverage . Providers and/or Suppliers should carefully review the medical record documentation to assure proper use of codes and medical necessity.

Avoid the request to Recover payments.

For more information regarding this blog or to inquire about our Consulting Services , please contact us:


Paul G. Silverio-Benet
305-975-1171


Our Services:
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