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
HCPCS G2212: Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact Evaluation and Management Documentation Requirements

78.59%
CPT® 80307: Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers, chromatography and mass spectrometry either with or without chromatography, includes sample validation when performed, per date of service Laboratory and Pathology Documentation Requirements

78.40%
CPT® 66984: Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); without endoscopic cyclophotocoagulation Surgery and Procedure Services Documentation Requirements

55.49%
Last Updated Oct 18 , 2024