Medicare, Cures for Billing Code Complexity: Hearing Before the Subcommittee on Human Resources of the Committee on Government Reform and Oversight, House of Representatives, One Hundred Fifth Congress, Second Session, April 9, 1998U.S. Government Printing Office, 1998 - 241 pages |
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administrative American Medical Association April 9 audit BARRETT billion Blue Cross Blue Shield BUIE chart clinical Code Complexity concerns Congressman contractor COOLEY coverage policies CPT codes criminal Cross and Blue Dermatology diagnosis diagnosis code DICKEY doctors documentation guidelines E/M services E&M codes evaluation and management exam False Claims Act federal fraud and abuse fund going HCFA health care hearing hospital implementation investigation issue Kansas City KOPF LEITCH level of E/M look management codes medical records medical review medical savings accounts Medical Society Medicare beneficiaries Medicare billing Medicare carrier Medicare patients Medicare program Medicare's medicine medigap nurse office visit panel payment penalties percent physicians practice price controls problem procedures question RBRVS Reform and Oversight regulations reimbursement Rheumatology ROBERTSON ROSENBERG SNOWBARGER specialty staff Subcommittee on Human Thank TILGHMAN U.S. attorney Vance Vince Snowbarger
Popular passages
Page 202 - Nothing in this title shall be construed to authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine or the manner in which medical services are provided...
Page 6 - I ask further unanimous consent that all witnesses be permitted to include their written statements in the record; and without objection, so ordered.
Page 8 - Ex OFFICIO DAN BURTON, Indiana HENRY A. WAXMAN, California LAWRENCE J. HALLORAN, Staff Director and Counsel...
Page 54 - Problem focused: Chief complaint; brief history of present illness or problem. Expanded problem focused: Chief complaint; brief history of present illness; problem pertinent system review. Detailed: Chief complaint; extended history of present illness; problem pertinent system review extended to include a review of a limited number of additional systems; pertinent past, family, and/or social history directly related to the patient's problems.
Page 1 - ... Management, Information, and Technology) presiding. Present: Representatives Horn, Sessions, Davis of Virginia, and Maloney, Subcommittee on Government Management, Information, and Technology; Representatives Snowbarger and Kucinich, Subcommittee on Human Resources. Ex officio present: Representative Waxman. Staff present: Lawrence J. Halloran, staff director and counsel; Marcia Sayer, professional staff member; R. Jared Carpenter, clerk; J. Russell George, staff director and counsel; Mark Uncapher,...
Page 50 - An age appropriate review of past and current activities that includes significant information about: • Marital status and/or living arrangements • Current employment • Occupational history • Use of drugs, alcohol, and tobacco • Level of education • Sexual history • Other relevant social factors System Review (Review of Systems) An inventory of body systems obtained through a series of questions seeking to identify signs and/or symptoms that the patient may be experiencing or has experienced.
Page 48 - A new patient is one who has not received any professional services from the physician or another physician of the same specialty who belongs to the same group practice, within the past three years.
Page 157 - For purposes of this section, the terms "knowing" and "knowingly" mean that a person, with respect to information — (1) has actual knowledge of the information; (2) acts in deliberate ignorance of the truth or falsity of the information; or (3) acts in reckless disregard of the truth or falsity of the information, and no proof of specific intent to defraud is required. (c) Claim defined. For purposes of this section, "claim...
Page 49 - E/M services recognize seven components that are used in defining the levels of E/M services. These components are: • History, • Examination, • Medical decision making, • Counseling, • Coordination of care, • Nature of presenting problem, and • Time. The first three of these components (ie, history, examination, and medical decision making) are the key components in selecting the level of E/M services.
Page 48 - Chief Complaint A chief complaint is a concise statement describing the symptom, problem, condition, diagnosis, or other factor that is the reason for the encounter, usually stated in the patient's words. Concurrent Care Concurrent care is the provision of similar services, eg, hospital visits, to the same patient by more than one physician on the same day. When concurrent care is provided, no special reporting is required. Modifier 75 has been deleted.