Skip Navigation LinksHome | Editors' Blog

On the heels of two similar settlements, a Baltimore health system has settled a case for $122,928 in which it was accused of getting the doctors whose practice it had acquired to bill established patients as if they were new, inflating their charges.

Some practices that frequently report E/M services with modifer 25 (Significant, separately identifiable E/M service) are on track to face a dramatic pay reduction.
Brace for a big shake-up to E/M coding. CMS announced its intention to pursue “comprehensive reform of E/M documentation guidelines” in the 2018 proposed Medicare physician fee schedule released July 13.
Two medical centers in Massachusetts will pay more than $700,000 to settle allegations that they upcoded claims when they failed to follow the rules for new and established patients.
Look to your diagnosis coding to understand whether a patient fits the criteria for new cognitive-assessment code G0505 because the code does not confer blanket coverage for your elderly patients.

Login

User Name:
Password:
Welcome to the new Part B News Online. If you are a returning user having trouble logging in, please click here.
Blog Archive
Back to top