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Palmetto GBA Prepayment Reviews

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By Bridget Krueger, MBA, RT(T)
April 12, 2012, 12:02pm

Palmetto GBA will perform a service-specific prepay probe review on outpatient claims in North Carolina, South Carolina, Virginia and West Virginia. There are 13 rad onc services they are reviewing because their data analysis showed significant frequency of these services. Can anyone guess the 13 codes?

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Replies

Sally, April 13, 2012, 10:39 am

They have chosen an interesting group of codes to review, majority of freuqently utilized procedure codes. It is interesting that they are just now publishing this information since we have been seeing these reviews for the past 2 months!

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