OIG looking at consults, E/Ms, modifier -25 in 2004

Why This Topic Matters

The article helps readers gauge where Medicare oversight was expected to intensify and what documentation and billing areas were drawing scrutiny. That makes it relevant for compliance review, internal auditing, and awareness of common claim types that may attract review.

Article Sections

1. OIG looking at consults, E/Ms, modifier -25 in 2004

   Introduces the article’s focus on Medicare oversight priorities in the OIG Work Plan for 2004 and the types of services expected to receive increased review.

2. Consultations

   Discusses consultation billing as a compliance focus and describes general circumstances that can raise questions about how services are categorized.

3. Coding Evaluation and Management Services

   Covers audit attention on evaluation and management services, including broader patterns in office visits and inpatient follow-up documentation.

4. Use of Modifier -25

   Addresses the scrutiny expected around same-day evaluation and management billing in relation to other services and claims review.