2013 OIG Work Plan: Expect scrutiny of electrodiagnostic claims, G modifiers

Why This Topic Matters

It helps readers identify which billing and documentation areas were likely to draw audit attention, supporting compliance review and preparation for Medicare oversight activity.

Article Sections

1. Electrodiagnostic tests

   This section discusses OIG attention to electrodiagnostic services and the broader billing oversight context for those tests. It also references the associated CPT code sets introduced or used during the period covered by the article.

2. Proper billing of liability-related G modifiers

   This section addresses Medicare claims review involving liability-related modifiers and the general compliance concerns tied to them. It frames the OIG’s interest in how these claims were handled over a multi-year span.

3. Payments for immunosuppressive drug claims with modifier KX appended

   This section covers oversight of immunosuppressive drug claims and the associated documentation and transplant-related context. It also highlights the modifier-focused nature of the review.

4. OIG drug shortages investigation

   This section summarizes the OIG’s planned review of drug shortages and their impact on physicians, reporting, and practice operations. It discusses the general policy and supply-chain concerns involved.

5. Ongoing investigations

   This section lists additional recurring Medicare oversight areas under continued review, including payment, utilization, and medical necessity topics. It also notes a specific Part B code referenced in the article.