医疗保险recently released allergy & immunology provider compliance data for 2021, which provides interesting information for our specialty.See the tips– select “Allergy Services” as the topic.
The good news is that allergy and immunology providers are extremely compliant when billing for Medicare Part B services!According to CMS, the improper payment rate for allergy and immunology providers billing Part B is just 1.9% – with a projected improper payment amount of $13 million. This amounts to a tiny fraction (0.1%) of overall improper Medicare payments. In fact, the allergy/immunology rate of 1.9% is one of the lowest improper payment rates of all the specialties examined, with the average for all provider types at 8.5%. See CMS’2021 Medicare Fee-for-Service (FFS) Supplemental Improper Payment Data(pages 49-50) for specialty comparison data.
For the 2021 reporting period, insufficient documentation accounted for 63.5% of errors for allergy and immunology providers. Incorrect coding caused the remaining 36.5% of improper payments.
医疗保险Local Coverage Article (LCA): Allergy Immunotherapy (A56424)has the most current HCPCS and CPT codes for our specialty. Medicare outlines other allergy-related policy requirements inLocal Coverage Determination (LCD): Allergy Immunotherapy (L32553)LCA A56424,LCD: Allergy Immunotherapy (L36408)andLCA: Billing and Coding: Allergy Immunotherapy (A57472).
