OIG to focus on imaging, E/M services in 2008

Why This Topic Matters

It helps readers anticipate government scrutiny areas that can affect documentation, billing workflows, compliance review, and claim submission accuracy for Medicare-participating providers.

Article Sections

1. MRI services

   This section discusses the OIG’s planned review of MRI-related arrangements and utilization patterns under the Medicare Physician Fee Schedule. It focuses on broad oversight of relationships among parties involved in imaging services.

2. Ultrasound services

   This section outlines the OIG’s review of ultrasound utilization in high-use areas of the country. It addresses Medicare payment oversight and medical necessity concerns at a general level.

3. E/M billed during global period

   This section covers the OIG’s review of evaluation and management services furnished during the global surgery period. It describes the general compliance issue and the historical context of the global surgery fee concept.

4. Medicare assignment rules

   This section summarizes the OIG’s interest in whether providers are following Medicare assignment requirements when billing beneficiaries. It references statutory authority and broad beneficiary billing restrictions.

5. POS errors

   This section addresses the OIG’s review of place-of-service coding accuracy and differences in payment tied to service location. It highlights oversight of claims reflecting whether services were performed in facility or non-facility settings.