COMPLIANCE: OIG Intends To Home In On Modifier GY Claims, POS Errors, And More In 2010

Why This Topic Matters

Providers and billing staff can use this overview to understand where federal review attention is directed in 2010 and to support internal compliance checks. It is relevant for practices that bill Medicare, work with emergency department imaging, or participate in incentive payment programs.

Article Sections

1. What The Work Plan Is

   Explains the purpose of the OIG Work Plan and the types of offices involved in carrying out reviews and audits during the fiscal year.

2. What Will The OIG Review?

   Provides general context on how the OIG approaches sampled claim reviews and why organizations may want to monitor their billing and claims processes.

3. X-Rays In EDs Under Fire

   Summarizes the planned review of diagnostic x-ray claims and medical records tied to hospital emergency departments and Medicare Part B payments.

4. Modifier GY Under Microscope

   Discusses the planned review of providers’ use of a specific Medicare modifier on claims for services that are not covered by Medicare.

5. E-Prescribing Pay Scrutinized

   Covers the planned examination of Medicare incentive payments related to e-prescribing activity and potential payment errors.