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CMS Medicare Quarterly Provider Compliance Newsletter – Billing Errors

CMS Medicare Quarterly Provider Compliance Newsletter – Billing Errors

The CMS Quarterly Provider Compliance Newsletter offers guidance to health care providers about common billing errors. This newsletter is designed to provide education on how to avoid common billing errors and other erroneous activities when dealing with the Medicare Fee For Service (FFS) Program.

One of the areas addressed in the most recent newsletter is billing errors for screening colonoscopies.   CMS has determined erroneous claims for screening colonoscopies are due to insufficient documentation.

Are your providers including the following information in their documentation for screening colonoscopies?

  • An order for the diagnostic procedure that included the rationale for the procedure and it signed and dated by the ordering physician.
  • Procedure note with physician signature
  • Progress note(s) with physician signature
  • Specific documentation if the patient is considered high risk and strategies implemented to minimize risk.

 

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