If you’re looking to self-audit your practice’s critical care claims, consider this tip from Dr. Bruce Rappaport, who taught us all about what government and payer auditors are looking for when we heard him speak at this summer’s Specialty Coding Conference in Orlando.
If your physician has billed for critical care, look at the notes from other clinicians surrounding your own physician’s note, recommends Dr. Rappaport.
Why? One thing critical care claims auditors do is look at notes from other nurses and doctors before and after the period of critical care your physician has billed, Dr. Rappaport explains. If notes from other clinicians say things like ‘patient stable and doing fine,’ ‘on the mend,’ or ‘expected to be released from ICU next day,’ for example, auditors are going to wonder why your physician has billed critical care.
If your doctor has simply checked a box somewhere and not explained in a note why a patient who had been stable required critical care to be resumed, auditors will dig deeper.
Get more self-audit tips straight from Part B Insider in next Friday’s edition of Coding News.
Did you miss Dr. Rappaport’s eye-opening instruction in Orlando this summer? Good news, there’s some awesome speakers are coming to Orlando again this December for the 2010 Billing & Collections Conference.
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