If Medicare carries out an audit and figures out that your documentation is not in proper order, you could find yourself having to repay them for all the claims they find problems with.
Medicare only sees the front portion of the form when you send in a CMS-1500 form. What Medicare fails to see is what is on the other side of that form, which is your documentation. They presuppose that your document is right until they carry out an audit.
If Medicare carries out an audit and figures out that your documentation is not in proper order, you could find yourself having to repay them for all the claims they find problems with. That is the reason why it is vital to cautiously document the medical necessity of the visual field exam in the patient's medical record.
According to experts, one of the weak areas of optometrists is the "interpretation and report" portion of several codes. For instance code 92083 provides one example. As per your record of a visual field, "Informed patient test for OD showed small area we need to watch; have return in three months." In a postpayment audit, Medicare will not accept this billing. Here's why? Interpretation and report" needs assessment of both eyes.
Bear in mind: All three visual field codes have a TC and PC. When you bill 92083, you are telling Medicare you performed both the TC and the PC. It is better to have a form just for visual fields, apart from your regular notes.
This may sound excess, but remember that in case of an audit, such a form could save you money.
For further details on this and for other medical coding updates, sign up for a one-stop medical coding guide like http://www.supercoder.com/.
If Medicare carries out an audit and figures out that your documentation is not in proper order, you could find yourself having to repay them for all the claims they find problems with. That is the reason why it is vital to cautiously document the medical necessity of the visual field exam in the patient's medical record.
According to experts, one of the weak areas of optometrists is the "interpretation and report" portion of several codes. For instance code 92083 provides one example. As per your record of a visual field, "Informed patient test for OD showed small area we need to watch; have return in three months." In a postpayment audit, Medicare will not accept this billing. Here's why? Interpretation and report" needs assessment of both eyes.
Bear in mind: All three visual field codes have a TC and PC. When you bill 92083, you are telling Medicare you performed both the TC and the PC. It is better to have a form just for visual fields, apart from your regular notes.
This may sound excess, but remember that in case of an audit, such a form could save you money.
For further details on this and for other medical coding updates, sign up for a one-stop medical coding guide like http://www.supercoder.com/.
No comments:
Post a Comment