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Audits Increase as Injections Increase – Retinal Physician

Prepare for the inevitable with proper documentation.

Injectable drugs for retinal disease — particularly ranibizumab (Lucentis; Genentech) and aflibercept (Eylea; Regeneron) — are the focus of audits for Medicare and other payers. How can you avoid problems?

This article addresses the following questions:

  • Why does Medicare devote so much attention to anti-VEGF drugs?
  • What documentation is required to support claims for anti-VEGF drugs?
  • Why does Medicare use a 28-day interval between injections?
  • What audits are currently active?
  • How should we respond to a TPE or other audit?
  • How can we protect ourselves from an audit?

This article was published in Retinal Physician, which is written by Corcoran’s Executive Vice-President, Suzanne Corcoran, COE. To view the entire article in Retinal Physician, click on the link below:

https://www.retinalphysician.com/issues/2019/july-august-2019/coding-q-amp;a-audits-increase-as-injections-incr

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