decisionhealth Newsletters, Coder Pink Sheets - 2012 Issue 11 (November)
Take note of OIG 2013 Work Plan repeat targets
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Article Overview
This article explains several recurring areas on the OIG 2013 Work Plan that signal continued audit attention for physician practices and other outpatient providers. It is intended for coding, compliance, and billing staff who need a broad understanding of the types of documentation and claim-reporting issues under review, especially around evaluation and management services, incident-to billing, and place-of-service accuracy. The article also points readers to related educational resources and official references.
Why This Topic Matters
Repeated OIG targets often indicate persistent billing and coding risk areas that can affect claim accuracy, audit exposure, and compliance efforts. Understanding the article’s focus helps practices prioritize internal review and staff education before issues are identified in an external audit.
Article Sections
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E/M services
Discusses recurring audit attention on evaluation and management services and related documentation and billing concerns. It also points to broader compliance review topics tied to outpatient visits and global surgery timing.
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Incident-to rules
Reviews incident-to billing as an audit focus and summarizes the compliance context for services reported under that framework. The section also references the need to distinguish physician and non-physician practitioner involvement in office-based care.
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Place-of-service (POS) guidelines
Covers recurring place-of-service reporting concerns and the settings mentioned in the article where errors have been identified. It also highlights the operational importance of correct POS selection in claim submission.
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Official resources
Lists the external references and supporting resources cited by the article for further reading and verification.
What You Will Learn
- Which recurring billing and coding areas the OIG continues to scrutinize
- How the article frames evaluation and management audit focus at a high level
- Why incident-to billing remains a compliance concern
- What kinds of place-of-service issues are being revisited in audit activity
- Which official and educational resources are referenced for follow-up
Who Should Read This
- Medical coders
- Billing staff
- Compliance officers
- Practice managers
- Physician offices
- Outpatient providers
Codes Discussed
Modifiers Discussed
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