What Medicare is auditing this year

According to Medicare:

Skin lesions and associated items

We will continue current compliance activities (including audits, recovery and review under the Practitioner Review Program) associated with skin lesion excisions, wounds and cryotherapy.

In 2010–2011 we will develop and implement compliance strategies focussing on upcoding of skin lesion and flap repair items and billing an item that is not substantiated by the required histopathology test.

We released a new eLearning product in late 2009 covering consultation items and the treatment of skin lesions. We will monitor the need for additional education tools to address other aspects of billing for these services.

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  1. #1 by hein vandenbergh on January 31, 2011 - 12:14 am

    I wonder how they are going to monitor cryotherapy compliance!!!! – whatever it may be…..

    As to eLearning, Medicare has an awful record in that area. Does anyone remember the discussion – such as it was – with that utterly dumb cow from Medicare about skin lesions at a Gold Coast SCSA conference? I think she left in tears, as she was shown up as utterly ignorant about the real day to day issues faced by skin ca doctors.

    Fear not: fly by the book, document, document, document, and nowt will befall you. If audited, be NOT intimidated – you will always know more than the failed doctor who does the auditing. Have someone else sit-in with you, need not be a lawyer. Ask to have the discussion either taped, or notes taken by the third person in the room. If nothing else, it’ll stop any attempt at intimidation or accusatory comments – and you have a contemporaneous account of what transpired. If they refuse your request, phone your medi defence organisation there and then, with the auditor in the room.

  2. #2 by Stewart Precians on February 13, 2011 - 10:50 am

    Hein mate, do you think auditing should not be done at all? Imagine how much income tax would actually be paid if there was no such thing as a tax audit? Not that I would like to volunteer for either, especially not the tax boys as it can cost a small fortune in accountants fees.

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