HOME >> MEDICINE >> NEWS
Study finds Medicare overbilling may be caused by government's faulty reimbursement

Washington, DC--In the midst of an ongoing crackdown on health care providers for allegedly overbilling federal health care programs, a study in the September 2002 Annals of Emergency Medicine finds the government's coding system used to determine physicians' Medicare payments is an unvalidated process prone to errors. (Reliability of Assigning Correct Current Procedural Terminology--4 E/M Codes)

"The American College of Emergency Physicians strongly supports government efforts to remove fraudulent practices from the Medicare program," said Michael L. Carius, MD, president of ACEP. "But the truth is that most of what the government calls fraud and abuse results from simple billing errors and the problems inherent in complying with Medicare's more than 100,000 pages of rules and supporting documents."

Nearly 9,000 Current Procedural Terminology (CPT) codes are used in the medical field to code medical procedures for Medicare claims. The codes describe the extent of a physician's interaction with a patient, such as obtaining the patient's medical history, performing a physical examination, and providing various levels of medical services. Each code is tied to a payment amount. The more complex the interaction between the patient and physician, the higher the code and level of payment.

This study focuses on the five evaluation and management (E/M) codes that represent 70 percent of the codes emergency physicians use to bill for the services they provide. E/M coding has received extraordinary attention by government auditors. The study's authors explain this is because most claims are billed under these codes, which represent less tangible services and have less precise definitions than other codes, opening them up to broader interpretation, and thus inviting more scrutiny.

To determine the reliability of the federal government's E/M coding system, Raymond E. Jackson, MD, and his team of investigators from William Beaumont Hospital Syste
'"/>

Contact: Colleen Horn
chorn@acep.org
202-728-0610
American College of Emergency Physicians
22-Aug-2002


Page: 1 2

Related medicine news :

1. Study of energy and health in Africa focuses spotlight on charcoal and forest management
2. Study shows promise in identifying kidney failure
3. Study shows patch therapy may be as effective as oral medications
4. Study shows soy is well accepted in school lunches
5. Study finds that coordinating care of chronically ill patients does not increase liability
6. Study provides new estimates of the causes of child mortality worldwide
7. Study finds factors linked to substance use disorder relapse among health care professionals
8. Study finds majority of women willing to accept cervical cancer vaccine for self and children
9. Study shows use of budesonide reduced the risk of asthma related events by 40% in children
10. Study shows risk of cardiac death after radiation for breast cancer has dramatically decreased
11. Study shows acrylamide in baked and fried food does not increase risk of breast cancer in women

Post Your Comments:
*Name:
*Comment:
*Email:


(Date:11/15/2018)... ... November 15, 2018 , ... Made of Millions, a nonprofit ... exhibit — Seen — to New York this month. The event will feature a ... to create environment that showcases mental health issues in a more experiential way,” said ...
(Date:11/15/2018)... ... 15, 2018 , ... Over the last decade, SABRE , the global ... for National Breast Cancer Foundation (NBCF) . A mission-driven organization and proud partner ... proceeds have helped launch the National Mammography Program which has provided almost ...
(Date:11/15/2018)... Ky. (PRWEB) , ... November 15, 2018 , ... ... Turner have recently invited four more skilled medical professionals to join their ... includes more procedures at its skin clinic, Skin Chic, and is expanding its ...
(Date:11/15/2018)... ... 15, 2018 , ... Mothers and babies across California are ... that puts vital health education resources right at their fingertips. The initiative between ... Plan effective 1/1/19), an affiliate of Blue Shield of California, and the ...
(Date:11/15/2018)... ... ... The National Cancer Institute estimates that 1.7 million new cases of cancer will ... and we typically associate the disease with old age, about 9 percent of cancers ... advanced therapies, increasing numbers of these patients survive their disease and face the consequences ...
Breaking Medicine News(10 mins):
(Date:11/15/2018)... ... November 15, 2018 , ... Ric Henry, President and Owner of Pendulum, ... or Consequences, New Mexico on Friday, November 2, 2018. Ric, who opened Sierra as ... of Directors. , Sierra Health Care Center has become known as one of ...
(Date:11/15/2018)... ... 15, 2018 , ... American Bancard, dba TouchSuite announced today ... Canadian markets. TouchSuite will underwrite merchants selling CBD products online or in ... of the risks associated with the industry. CBD accounts will be boarded via ...
(Date:11/15/2018)... (PRWEB) , ... November 15, 2018 , ... Joint ... orthopedic institution in the Midwest, is one of only nine group practice centers in ... Two of the most common surgeries Americans undergo each year—knee and hip replacement—will be ...
Breaking Medicine Technology:
Cached News: