Medically unnecessary services and incorrectly coded items had the highest amounts of RAC overpayments collected in the demonstration project, according to CMS.
Most agree that the passage of the Patient Protection and Affordable Care Act will be a “game changer” in how physicians and their facilities will be reimbursed in the coming years.
For years the demand for coders has exceeded supply, and for many possible reasons. This may be because coders do not think that salaries are commensurate with the knowledge, expectations, and stress. And coders often move on to other positions and do not make a career of coding.
Editor’s note: Use this quiz to prepare staff members for ICD-10-PCS by expanding their knowledge of root operations for surgery. In future months, we will feature quizzes on anatomy and physiology to help coders continue to prepare for the transition.
Certain modifiers are well-known as being difficult for coders. (Modifier -59, anyone?) Others, particularly HCPCS level II modifiers, may be a challenge because they are new, more complex, or simply used infrequently on your hospital’s claims.
