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CodeMap® Compliance Briefing: 04/04/2008


Editor's Welcome:

Almost all health care providers with compliance related duties have faced a situation where there is no clear-cut answer. Often times, providers are forced to choose between two compliance options, neither of which truly describes what was performed, where it was performed, by whom it was performed, or how it was performed. Examples include esoteric procedures that are not accurately described by any procedure code. Another example, the Medicare contractor's billing system will not accept the supplier type code and place of service code that best report the provider's situation. In these scenarios providers must operate somewhat in the dark, and make the best choice possible. Today's briefing will discuss how to react to these situations and a provision of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) that offers some assistance to providers struggling....

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