Text of Recommendation | We recommend that the Centers for Medicare & Medicaid Services establish CWF system edits to detect instances in which practitioners incorrectly use the nonfacility place-of-service code 32 (NF or SNF with no Part A coverage) while an enrollee is a Part A SNF inpatient and the nonfacility place-of-service-code causes a higher payment rate, and direct its Medicare contractors to apply these recommended CWF system edits retroactively or otherwise reprocess the claim lines for similarly coded physician services furnished after our audit period and before CMS establishes these edits. |
---|---|
Recommendation Number | 23-A-04-080.03 |
Recommendation Status | Open |
Significant Recommendation | No |
Recommendation Questioned Costs | $0 |
Recommendation Funds for Better Use | $0 |
Submitting OIG | |
---|---|
Linked Report |