Washington Connexion April 25, 2012
Written by: MGMA Government Affairs

CMS releases top auditor issues

The Centers for Medicare & Medicaid Services (CMS) released its current quarterly newsletter aimed at helping providers, suppliers and their billing staffs understand and avoid certain billing errors. The newsletter identifies top billing errors identified by CMS contractors like the Recovery Audit Contractors (RACs), Zone Program Integrity Contractors (or ZPICs) and Comprehensive Error Rate Testing (CERT) findings.

CMS identifies and provides guidance on avoiding 7 common billing errors, including one related to physician Evaluation and Management (E/M) codes provided to hospital inpatients since the elimination of consultation codes. Links to previous editions of this newsletter, along with an index to the issues CMS has addressed, can be found on MGMA’s RAC Resource Center.

RACs are now required to review claims of all provider types, including physicians, and more of our members are hearing from them. MGMA Government Affairs has prepared an educational Webinar to help members respond to RACs, including how to appeal a RAC’s findings and the implications of not appealing. Register for the session on May 3 here. Participants will have an opportunity to submit questions ahead of the presentation.