Medical Record Review Results

Noridian Medical Review (MR) has analyzed findings as a result of Targeted Probe and Educate (TPE) review. The goal of MR is to reduce claim errors by identifying services with top trending errors and providing relevant education. MR encourages providers to review this information to ensure compliance with documentation, billing, and coding guidelines.

Review Criteria Required Documentation Current Error Rate Review Results
CPT® 99291: Critical care, evaluation and management of the critically ill or critically injured patient; first 30-70 minutes Evaluation and Management Documentation Requirements 78.84%
CPT® 99310: Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded. Evaluation and Management Documentation Requirements 77.13%
CPT® 72148: Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material Radiology Documentation Requirements 80.01%
Last Updated Oct 18 , 2024