decisionhealth Newsletters, Part B News - 2014 Issue 4 (April)
OIG sets its sights on questionable billing of nerve conduction, EMG tests
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Article Overview
This article summarizes an HHS Office of Inspector General review of billing patterns for nerve conduction and electromyography services and CMS’s response to the findings. It is relevant to coders, compliance teams, neurologic and rehabilitation practices, and organizations monitoring audit risk because it discusses the broad types of claims patterns that drew concern, the agencies involved, and the general context of code changes and review activity without providing coding instructions.
Why This Topic Matters
It highlights an area of increased audit attention for electrodiagnostic testing and shows how federal review findings can affect billing oversight, compliance monitoring, and provider scrutiny.
Article Sections
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Billing
Introduces the article’s focus on claim scrutiny for electrodiagnostic services and the federal review context behind that attention.
What You Will Learn
- What federal agencies are reviewing electrodiagnostic billing patterns
- What broad types of claim behavior drew scrutiny
- What categories of providers were discussed in relation to the review
- How code set changes and review activity are framed in the article
Who Should Read This
- Medical coders
- Billing and compliance staff
- Neurology practices
- Physical medicine and rehabilitation practices
- Audit and risk management professionals
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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