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NGS to Conduct Audits for Certain Services - Teleconference October 17
Posted on: 10/11/2013

National Government Services (NGS) will begin performing audits on claims for services considered highly likely to be paid incorrectly, as contractually required by the Centers for Medicare and Medicaid Services.

The claims targeted for review are level 5 evaluations and management services for Part B (the CPT-9 codes are 99205 and 99215). If one of your claims is selected for review, you will receive a request to submit additional documentation, due within 30 days.

Why the audits? The CPT codes mentioned above are in the top 15 codes identified for improper payment rates. National Contractor Error Rate Testing (CERT) data shows a projected rise in the improper payment rate for 2013.

For more information, view NGS' announcement on Service-Specific Prepay Audits of Outpatient Evaluation and Management Services; access the Documentation Guidelines for Evaluation and Management (E/M) Services (level 5).

Ask-the-Contractor Teleconference    

Dial in for the final teleconference on the transition to National Government Services (NGS) for Medicare Part B, being held on October 17 at 9:30 a.m. (CST).

Dial in number: 866-308-0254 
Conference ID number: 513-419-3655

Questions? Call your ISMS Advocacy Team at 800-782-4767 ext. 1470 or send an email.

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