Examples of Medicare’s Top Billing Errors

September 5, 2005

The TrailBlazer Provider Communication department has identified the “Top 10 Billing Errors” through a data analysis program. Trailblazer¬†is the Medicare fiscal intermediary for Texas and other states. This error listing will be published on a quarterly basis.

Use this table to see if you medical practice or medical practice client is making the same errors:

Top 10 Billing Errors

Occurrences

1. Duplicates 421,949
2. Beneficiary Eligibility 100,831
3. Bundled Services 85,134
4. Medical Necessity 65,964
5. Medicare Secondary Payer (MSP) 45,828
6. Non-covered services 45,129
7. Procedure code/Modifier invalid 29,940
8. Modifiers 21,679
9. Provider Number Missing 19,827
10. CLIA 19,776

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