decisionhealth Newsletters, Coder Pink Sheets - 2011 Issue 6 (June)
OIG finds documentation deficient on emergency department imaging
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Article Overview
This article covers an April 2011 OIG report on diagnostic radiology documentation in hospital emergency departments, including findings related to claim support, physician orders, timing of interpretations, and Medicare payment review activity. It also discusses CMS’s response, planned education and contractor review actions, and references to Medicare guidance that affect radiology documentation oversight. The piece is aimed at radiology, emergency department, compliance, and revenue cycle professionals who need to understand documentation expectations and audit risk at a high level.
Why This Topic Matters
Emergency department imaging documentation can affect whether claims are supported, reviewed, or denied, and the article highlights federal audit attention and contractor enforcement activity around these services.
Article Sections
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OIG report findings on emergency department radiology documentation
Summarizes the federal review of imaging documentation practices in hospital emergency departments and the broad categories of documentation concerns identified.
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CMS response and audit follow-up
Describes CMS’s stated actions, including provider education and contractor review activity, in response to the report.
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Medicare policy references and contractor guidance
Covers the article’s discussion of Medicare manual references and general contractor handling of interpretation-and-report claims in the emergency department setting.
What You Will Learn
- What the article says about documentation concerns in emergency department imaging
- How the report relates to Medicare payment oversight and audit activity
- Which federal organizations and guidance sources are discussed
- What general compliance areas are emphasized for radiology services in the ED
Who Should Read This
- Radiology coders
- Compliance staff
- Revenue cycle teams
- Emergency department billing staff
- Physicians and practice managers
- Audit and CDI professionals
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