decisionhealth Newsletters, Coder Pink Sheets - 2010 Issue 10 (October)
OIG: Transforaminal injections often billed incorrectly
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Article Overview
This premium article discusses an OIG report on Medicare payment errors associated with transforaminal epidural injection services. It covers the broad findings, the types of billing and documentation problems identified, and the kinds of CMS and contractor responses the report urges. The article is relevant to coders, compliance staff, and providers who bill injection procedures and want to understand the policy and audit focus surrounding these claims.
Why This Topic Matters
The article matters because it signals increased audit attention and potential local coverage and claims-edit changes affecting how these services are billed and reviewed under Medicare.
What You Will Learn
- What the OIG reviewed in relation to Medicare billing for transforaminal epidural injection services
- What kinds of billing and documentation issues were highlighted in the report
- What general policy and contractor actions the OIG recommended to address improper payments
- Why these findings are relevant to providers, coders, and compliance teams
Who Should Read This
- Medical coders
- Compliance staff
- Physician practices
- Pain management providers
- Revenue cycle teams
- Auditors
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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