Facet injections often improperly reported, OIG report says

Why This Topic Matters

The discussion helps readers recognize why facet injection claims drew audit scrutiny and why Medicare contractors’ billing policies can affect payment accuracy. It is useful for teams reviewing claim compliance, reimbursement variance, and documentation practices for these services.

Article Sections

1. OIG audit findings and Medicare scrutiny

   Summarizes the audit context, the Medicare claims being reviewed, and the general compliance issues identified by the government report.

2. Facet injection coding basics

   Introduces the relevant facet injection code family and describes the broad distinction between primary and add-on reporting.

3. Bilateral reporting and payment issues

   Discusses how bilateral reporting has been handled in claims and why payment differences can arise across reporting approaches.

4. Carrier policy differences and overpayment concerns

   Describes variation among Medicare contractors and the resulting reimbursement inconsistencies seen by practices and facilities.

5. Practical compliance takeaway

   Provides a general reminder to review claims and contractor guidance when facet injection billing policies differ.