Comparative Billing Reports

Some of you may be receiving Comparative Billing Reports (CBR) from CMS, and you are wondering what to do.

The CBRs sent out over the last couple of months are for ophthalmic services codes (92002-92014). (Example of CBR) These reports compare your billing of these codes with other ophthalmologists in your state and around the country, although they do not separate by specialty taxonomy code.

A CBR will present the results of statistical analyses that compare an individual provider’s billing practices for a specific billing code or policy group with the billing practices of that provider’s peer groups and national averages. Each CBR is unique to a single provider and is only available to that individual provider; they are not publicly available.  They can show that some providers may need additional review and education.

You are not required to respond to a CBR because it is not a notice that an audit is imminent. The CBR letter specifically states, “Receiving this CBR is not an indication or precursor to an audit, and it requires no response on your part.”  However, an acknowledgment that you received the letter and are following up is advisable.

A few other things that you should do if you receive a CBR:

• Read the CBR thoroughly and take it seriously.
• Make sure you are submitting from the proper family of exam codes.
• Conduct your internal chart audit, or enlist Corcoran Consulting Group to conduct an audit to assure compliance.
• If documentation does not meet the level of the exam billed, contact Corcoran Consulting Group for auditing and documentation training and education. 

We are available and happy to assist you with issues such as this and other topics related to eye care reimbursement.  We are still presenting our training webinars related to changes in 2021 on Evaluation and Management eye exam coding.  We are also pleased to announce that we have 2 new webinars on chart documentation and auditing for the 2021 E/M guidelines.  Contact us if you are interested.

www.corcoranccg.com (800) 399-6565

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