Billing Compliance Alert: Special Audit Procedure Begins Today
A prepayment review audit for CPT codes 99215 (follow-up outpatient visit, high complexity), 99291 (critical care services first 30-74 min.) and 99232 and 99233 (subsequent hospital visits moderate–high complexity) is being implemented for claims processed on or after March 15, by Florida’s Medicare carrier, First Coast Service Options.
In addition, a post-payment review audit for CPT code 99214 (follow-up outpatient visit, moderate complexity), is being implemented for claims processed on or after March 15.
Please make sure that when submitting a claim for these services, the medical necessity and documentation support the level of care billed.
If you have any questions, please contact the Office of Billing Compliance at 305-243-5842.