References
- AMA. CPT® Assistant. March 2012.
- CMS. Global Surgery Booklet. August 2017. Available online at: cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/GloballSurgery-ICN907166.pdf. Last accessed October 10, 2017.
- CMS. National Correct Coding Initiative Policy Manual for Medicare Services. Available online at: cms.gov/Medicare/Coding/NationalCorrectCodInitEd/NCCI-Manual-Archive.html. Last accessed October 10, 2017.
- CMS. Medicare Benefit Policy Manual: Chapter 6 — Hospital Services Covered Under Part B. Available online at: cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/bp102c06.pdf. Last accessed October 10, 2017.
- CMS. OPPS Visit Codes Frequently Asked Questions. Available online at: cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalOutpatientPPS/Downloads/OPPS_QandA.pdf. Last accessed October 10, 2017.
- CMS. Medicare Claims Processing Manual: Chapter 4 — Part B Hospital (Including Inpatient Hospital Part B and OPPS). Available online at: cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c04.pdf. Last accessed October 10, 2017.
- Noridian Healthcare Solutions. E/M Services and Drug Administration Billing. Available online at: med.noridianmedicare.com/web/jfa/policies/coverage-articles/em-services-and-drug-administration-billing. Last accessed October 10, 2017.
- OIG. Use of Modifier 25. Available online at: oig.hhs.gov/oei/reports/oei-07-03-00470.pdf. Last accessed October 10, 2017.
- OIG. Coding Trends of Medicare Evaluation and Management Services. Available online at: oig.hhs.gov/oei/reports/oei-04-10-00180.pdf. Last accessed October 10, 2017.
- DOJ. Easton Hospital Agrees to Pay Government $454,866 to Resolve Allegation of Improper Medicare Claims. April 3, 2013. Available online at: justice.gov/usao-mdpa/pr/easton-hospital-agrees-pay-government-454866. Last accessed October 10, 2017.
- DOJ. St. Luke's University Health Network Agrees to Pay Government $1,029,791 to Resolve Alleged Improper Medicare Claims. April 3, 2013. Available online at: justice.gov/usao-mdpa/pr/st-luke-s-university-health-network-agrees. Last accessed October 10, 2017.
- FBI. Leading Oncology Practice to Pay $4.1 Million to Settle False Claims Act Investigation. September 19, 2012. Available online at: archives.fbi.gov/archives/atlanta/press-releases/2012/leading-oncology-practice-to-pay-4.1-million-to-settle-false-claims-act-investigation. Last accessed October 10, 2017.
- DOJ. Dermatology Physicians and Practice to Pay $1.9 Million to Settle False Claims Act Investigation into Overbilling Medicare for Evaluation and Management Services. April 18, 2016. Available online at: justice.gov/usao-ndga/pr/dermatology-physicians-and-practice-pay-19-million-settle-false-claims-act. Last accessed October 10, 2017.
- Felger TA, Felger M. Understanding when to use Modifier-25. Fam Pract Manag. 2004 Oct;11(9):21–22. Available online at: aafp.org/fpm/2004/1000/p21.html. Last accessed October 10, 2017.