Identifying Charting And Coding Risks – Review of Ophthalmology

Considerations to keep in mind as practices face continued charting and documentation scrutiny from government agencies.

This article answers the following questions:

• What agencies should we be concerned with that may be scrutinizing our documentation and coding?
• Is there a listing of what issues are being scrutinized by these organizations?
• What are some areas of scrutiny that I can self-audit or advise my staff to be particularly cognizant of?
• Are any surgical services under the microscope for these agencies?
• Are drug payments to physicians still a concern for ophthalmologists and, if so, what steps can we take to improve compliance?
• If I own an optical dispensary and file claims for post-cataract eyeglasses, are there specific issues that involve this component of my practice?
• If my optical shop is inspected, are there common errors made on post-cataract eyeglass claims that could jeopardize my reimbursement and re-enrollment?
• Are there any documentation issues associated with diagnostic tests that could be viewed unfavorable by these agencies or any third party payer audit?
• As we transition to electronic medical records, are there “red flags” that we should consider?
• What steps can we take to mitigate our concerns about these and other targeted issues?
• Is this scrutiny likely to diminish over time?

This article was published in Review of Ophthalmology’s Medicare Q & A column, which is written by Corcoran’s Vice-President, Donna McCune, CCS-P, COE, CPMA. To view the entire article in Review of Ophthalmology, click on the link below:

http://bt.e-ditionsbyfry.com/publication/?i=152821

See page 19.