Consultations in Medicare: Coding and Reimbursement (PDF; 744 KB)

"This report found that in 2001, Medicare allowed $1.1 billion in improper payments for services billed as consultations. Medicare allowed approximately $191 million more than should have been allowed for services that were billed as consultations, but did not meet Medicare's definition of a consultation. Medicare and its beneficiaries overpaid an additional $613 million for consultations that were billed as the incorrect type or level of complexity and $260 million for undocumented consultations. Consultations billed at the highest billing level (the most complex services, which generate the highest reimbursements under the Medicare physician fee schedule) and follow-up inpatient consultations were particularly problematic; approximately 95 percent of each were miscoded or undocumented."
Source: Department of Health and Human Services, Office of Inspector General
Originally posted by ResourceShelf's DocuTicker