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Back up your 99024 reporting – OIG is watching

The post-operative visit code may not have its own payment rate, but the HHS watchdog is studying it anyway. Here's why.

If your practice has been submitting unpaid post-operative visit code 99024 as part of Medicare’s effort to collect information on global-period services, make sure you have the documentation on file to back up that service.

The HHS Office of Inspector General (OIG) announced in the July update to its work plan that it will begin reviewing “a sample of global surgeries to determine the number of post-operative services documented in the medical records and compare it to the number of post-operative services reported in the data collected by CMS."

In addition, OIG says “we will verify the accuracy of the number of post-operative visits reported to CMS by physicians and determine whether global surgery fees reflected the actual number of post-operative services that physicians provided to beneficiaries during the global surgery period." The agency plans to release the report next year.

Oncology surgeons topped the list of specialists participating in the collection effort, with a 92% reporting rate, followed closely by hand surgeons (90%) and orthopedic surgeons (87%), CMS stated in the proposed 2019 physician fee schedule.

In the last six months of 2017, CMS says more than 32,500 providers in nine states reported 990,581 post-operative visits using code 99024. Practices of 10 or more clinicians in those selected states have been designated to report the non-payable post-operative visit code for follow-up care provided for 293 high-volume 10- and 90-day procedures.

CMS will use the data collected from the effort to assess whether the surgical codes’ post-operative care valuation is accurate.

Blog Tags: OIG
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