Fraud and Abuse: Watchdog Barks Out Dirty-Dozen List of Coding Errors

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This article reviews an HHS Office of Inspector General Work Plan itemizing several billing and coding areas likely to face scrutiny. It is relevant to physicians, coders, compliance staff, and practice managers who track Medicare oversight, documentation risk, and fraud-and-abuse enforcement trends. The discussion covers broad categories such as evaluation and management coding, consultation billing, modifier use, place-of-service reporting, ESRD-related payment issues, home health oversight, diagnostic testing, excluded providers, and radiation therapy reimbursement.

Why This Topic Matters

The article helps readers understand which broad billing and coding practices are drawing federal attention so they can assess compliance risk and monitor areas commonly audited or reviewed.

What You Will Learn

  • Which broad billing and coding areas are included in the OIG Work Plan review
  • How federal oversight connects to common Medicare compliance concerns
  • What general types of physician and facility billing topics are being monitored
  • Which practice areas may warrant closer internal review and documentation attention

Who Should Read This

  • Physicians
  • Medical coders
  • Billing staff
  • Compliance officers
  • Practice managers
  • Healthcare auditors

Codes Discussed

Modifiers Discussed


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