What must be reviewed to ensure accuracy during a post-payment audit?

During a post-payment audit, it is essential to review the accuracy of qualifying circumstances codes because these codes provide critical context for the services rendered. Qualifying circumstances codes, which are used alongside the anesthesia codes, help clarify the specific conditions that may have influenced the complexity and intensity of care provided. Incorrect or inaccurate coding can lead to significant reimbursement issues or compliance violations, making it vital to ensure that the circumstances justify the level of service billed.

While patient age, anesthesia provider qualifications, and pre-operative diagnoses are also important factors in the overall medical record and billing process, they do not directly impact the accuracy of the service codes in the way that qualifying circumstances codes do. Thus, verifying the qualifying circumstances codes is crucial for maintaining compliance and ensuring appropriate reimbursement in a post-payment audit scenario.