Physicians may be angry at the increased documentation, coding, and billing workflow and compliance activities they must perform to be successful in new reimbursement models. However, to avoid accustations of fraud and upcoding, they must develop their own OIG-recommended compliance plan and be open to rigorous feedback and advice.
What are some examples of extenuating circumstances that could be modified with an -XU modifier (unusual nonoverlapping service) if none of the other -X modifiers are applicable?
This April, CMS made a switch, changing the volume of charts allowed for Quality Improvement Organization (QIO) short-stay audits. Prior to this change, the number of charts selected for audit ranged from 10 charts for small hospitals to 25 charts for larger hospitals. Now, the 175 hospitals with the highest volume of short stays will have 25 charts audited, while hospitals with a “Major Concern” rating on a previous audit will receive a request for 10 charts.
