The newsletter described each problem identified by Medicare claims processing contractors, RACs, program safeguard contractors, ZPICs and other governmental organizations. One of the common billing errors identified in the April edition was for oxaliplatin. According to the report, contractors and auditors still see many outpatient hospitals incorrectly calculating the number of service units billed for the anti-cancer chemotherapeutic agent.
The newsletter also noted that RAC findings have seen physicians, NPPs and outpatient hospitals billing excessive units of untimed codes. CMS said providers should use untimed codes to bill for services not defined by specific timeframes. However, regardless of the length of the evaluation of service, billers should bill only one unit of an untimed code for a patient, per date of service.
The newsletter also noted issues with the technical component of radiology provided by suppliers, physicians and NPPs. CMS reminded providers that the TC of radiology services in a PPS hospital setting cannot be billed separately to Part B.
Read the AAPC report on the CMS newsletter.
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