Home | 1/23/2017 Issue | Article

Lab tests without proper documentation, undercoded E/M cause improper payments

Effective Jan 23, 2017
Published Jan 23, 2017
Last Reviewed Apr 20, 2017
The list of Part B services with the most improper payments estimated by CMS for 2016 includes some of your most-billed services, according to data from the Comprehensive Error Rate Testing (CERT) program and other sources and published annually in the Medicare Fee-for-Service Improper Payments Report. Note that failure to establish medical necessity isn’t usually a factor; the mistake is more likely due to a coding error or a shortfall in documentation.

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