4 CPT Codes With the Greatest Number of Improper Payments Due to Site-of-Service Errors

Medicare Part B reimburses physicians at a higher rate for certain services performed in their offices to account for the increased expense, but when physicians perform those services in facility settings such as a hospital, Medicare reimburses the overhead expenses to the facility, according to a Medicare Learning Network newsletter (pdf).

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CMS has found four CPT codes that have resulted in the greatest number of improper payments based on dollars paid or number of claims paid due to site-of-service errors:

•    99291 — critical care first hour
•    85097 — bone marrow interpretation
•    96118 — neuropsychological testing
•    90801 — psychiatric diagnostic interview examination

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Related Articles on Coding:

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CMS Releases Physician Fee Schedule, Includes 27.4% Cut to Physician Payments

OIG: Medicare Contractors Overpaid Physicians $28.8M in 2008-09 for Incorrectly Coded Services

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