Review of Outpatient Claims Processed by Wisconsin Physicians Service That Included Procedures for the Insertion of Multiple Units of the Same Type of Medical Device in Calendar Years 2008 and 2009

摘要

Our audit covered $32,860 in Medicare outlier payments to hospitals for 14 claims for outpatient procedures that included the insertion of more than 1 of the same type of medical device. The 14 claims had dates of service during calendar years (CY) 2008 and 2009. Our objective was to determine whether Medicare paid hospitals correctly for outpatient claims processed by WPS that included procedures for the insertion of multiple units of the same type of medical device.