decisionhealth Newsletters, Part B News - 2022 Issue 2 (February)
OIG audit targets excessive billing for genetic testing
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Article Overview
This compliance-focused article reviews an Office of Inspector General report on Medicare Part B genetic testing spending, the rapid growth in payments to laboratories, and the increase in labs and ordering providers over the review period. It is relevant to coding, compliance, audit, and fraud-prevention audiences who need a high-level understanding of the testing categories, the affected code sets, and the government oversight context without the full premium analysis.
Why This Topic Matters
The article highlights a federal audit concern involving rapidly increasing genetic testing expenditures under Medicare and explains why the topic is important for compliance monitoring, billing review, and fraud-prevention efforts.
What You Will Learn
- How an OIG review framed recent growth in Medicare genetic testing spending
- Which broad genetic testing categories were highlighted in the audit discussion
- Why the article connects genetic testing billing patterns to compliance and fraud concerns
- How the OIG’s earlier fraud alert and enforcement focus provide context for the report
Who Should Read This
- Medical coders
- Compliance officers
- Billing managers
- Auditors
- Revenue cycle professionals
- Healthcare fraud prevention staff
Codes Discussed
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