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CMS overpaid $636M to ASCs, HOPDs for neurostimulator implantation surgeries, audit finds
The Office of Inspector General found CMS overpaid $636 million for neurostimulator implantation surgeries between 2016 and 2017, according to an audit of outpatient hospital and ASC claims.
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CMS overpaid $636M to ASCs, HOPDs for neurostimulator implantation surgeries, audit finds
Patsy Newitt - Monday, October 25th, 2021 Print | Email
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The Office of Inspector General found CMS overpaid $636 million for neurostimulator implantation surgeries between 2016 and 2017, according to an audit of outpatient hospital and ASC claims.
The audit covered $1.4 billion in Medicare payments for 61,125 neurostimulator implantation surgery claims, the OIG said Oct. 1.
The office found that more than 40 percent of the healthcare providers did not comply with CMS requirements when they billed for neurostimulator implantation surgeries, totaling $636 million in overpayments.
The office recommends healthcare providers mitigate these errors by running a report on the CPT codes (61885, 61886 and 63685) and identifying the frequency, provider, dates of service and total charges of the procedures.
The OIG also identified action items for CMS, including identifying and recovering potential overpayments.