CMS overpaid $636M to ASCs, HOPDs for neurostimulator implantation surgeries, audit finds 

The Office of Inspector General found CMS overpaid $636 million for neurostimulator implantation surgeries between 2016 and 2017, according to an audit of outpatient hospital and ASC claims. 

Advertisement

The audit covered $1.4 billion in Medicare payments for 61,125 neurostimulator implantation surgery claims, the OIG said Oct. 1. 

The office found that more than 40 percent of the healthcare providers did not comply with CMS requirements when they billed for neurostimulator implantation surgeries, totaling $636 million in overpayments.

The office recommends healthcare providers mitigate these errors by running a report on the CPT codes (61885, 61886 and 63685) and identifying the frequency, provider, dates of service and total charges of the procedures. 

The OIG also identified action items for CMS, including identifying and recovering potential overpayments. 

Read more here.  

At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.

Register to Attend Webinar

Is ambulatory care healthcare’s big margin engine? 4 leaders weigh in

Wednesday, July 29
1:00 PM - 2:00 PM CDT

Presenters: Joe Ganley, athenahealthJeffrey Flynn, CASC, Gramercy Surgery CenterBryan Tsao, Access Center, Loma Linda University HealthJason Zepeda, Northridge Hospital Medical Center, CommonSpirit HealthGreg DeConciliis, PA-C, CASC, Boston Out­Patient Surgical Suites

Advertisement

Next Up in ASC Coding, Billing & Collections

Advertisement

Comments are closed.