Musings of a Dinosaur

A Family Doctor in solo private practice; I may be going the way of the dinosaur, but I'm not dead yet.

Thursday, February 08, 2007

New Definition of "Chutzpah"

From a discussion among FPs about undercoding:

Granted that we should all be accurately coding all of our services all of the time, nevertheless the question came up about Medicare fining us for undercoding. Was this possible, in that undercoding would seem to cost Medicare less?

Never underestimate Medicare:
A physician coded the wrong joint for injection (minor joint instead of major) and Medicare came along two years later and wanted a refund of their incorrect (lower) payment. It was then too late for [the physician] to bill the correct code/service.
I have now officially seen it all.

2 Comments:

At Thu Feb 08, 08:59:00 AM, Blogger The Independent Urologist said...

That actually happened to a friend of mine, who is a podiatrist. Medicare determined that he billed at a lower rate than the majority of podiatrists in his area, and asked for a refund of several thousand dollars. And, as in the above case, he had passed the time allowed for a re-submit.
Seems like a scam to me.

 
At Thu Feb 08, 08:38:00 PM, Blogger Bohemian Road Nurse... said...

I can't tell you how much I hate the ICD-9 book...

 

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