News You Can Use: Keep an Eye on Your 2016 Prolonged Services, Home Visits

Why This Topic Matters

Practices that report evaluation and management services need to understand what federal reviewers are focusing on so they can evaluate documentation, medical necessity, and compliance risks before audits or reviews occur.

Article Sections

1. Rarely Report Prolonged Services

   Discusses the OIG’s 2016 review focus related to prolonged services within evaluation and management reporting, including the compliance concerns raised for practices that use these services. It also places the topic in the context of CPT 2016 and documentation expectations.

2. Prove Medical Necessity For Home Visits

   Covers the OIG’s attention to home visit services and the documentation themes associated with medical necessity and patient travel limitations. The section also references reporting considerations for new and established patient home visit service categories.

3. Bonus

   Notes an additional compliance-related item mentioned as absent from the 2016 OIG Work Plan while still remaining relevant to reviewers. The discussion is framed as a caution for practices following the work plan.