Facilities that perform outpatient surgery must report the right place-of-service code, according to an AAPC report.
The Office of the Inspector General recommended several audit and recovery actions to CMS in a Sept. 7 report, after finding 83 percent of a sample of POS 11 claims were miscoded and overpaid in 2009.
The OIG found in its sample of 100 claims that only 17 services were coded correctly. The other 83 were reported as nonfacility POS codes when the services were in fact performed in hospitals or surgery centers. The incorrect coding resulted in overpayments that came to $2,979.
The OIG estimated Medicare contracts overpaid physicians $9.5 million during 2009, based on the number of claims with POS 11. The OIG recommends CMS have its contracts recover the $2,979 in overpayments for the sampled services and strengthen its education process to re-emphasize to physicians and billing agents the importance of correctly coding the POS.
Related Articles on Coding, Billing and Collections:
TeamHealth Expansion to Create Hundreds of Medical Coding and Billing Jobs
Providers Could Save Time, Money by Implementing ICD-10 and Meaningful Use Together
Employer Healthcare Expenses Predicted to Rise at Lowest Rate Since 1997
The Office of the Inspector General recommended several audit and recovery actions to CMS in a Sept. 7 report, after finding 83 percent of a sample of POS 11 claims were miscoded and overpaid in 2009.
The OIG found in its sample of 100 claims that only 17 services were coded correctly. The other 83 were reported as nonfacility POS codes when the services were in fact performed in hospitals or surgery centers. The incorrect coding resulted in overpayments that came to $2,979.
The OIG estimated Medicare contracts overpaid physicians $9.5 million during 2009, based on the number of claims with POS 11. The OIG recommends CMS have its contracts recover the $2,979 in overpayments for the sampled services and strengthen its education process to re-emphasize to physicians and billing agents the importance of correctly coding the POS.
Related Articles on Coding, Billing and Collections:
TeamHealth Expansion to Create Hundreds of Medical Coding and Billing Jobs
Providers Could Save Time, Money by Implementing ICD-10 and Meaningful Use Together
Employer Healthcare Expenses Predicted to Rise at Lowest Rate Since 1997