Part B Coding Coach: Check Out These Six Ob-Gyn 2014 OIG Work Plan Hot Spots

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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 several Medicare Part B compliance focus areas from the 2014 OIG Work Plan as they relate to ob-gyn and related specialties. It is aimed at practices and billing staff who want a broad sense of the types of claims, services, and documentation areas likely to attract audit attention, including imaging, electrodiagnostic testing, laboratory services, physician/supplier billing, and outpatient drug administration. The article also references select CPT and Medicare policy materials in a general compliance context.

Why This Topic Matters

It helps ob-gyn practices understand which service categories were under review and why documentation, medical necessity, and billing accuracy matter for Medicare Part B claims compliance.

Article Sections

  1. Diagnostic radiology potential minefields

    Discusses Medicare’s review focus on higher-cost imaging services and related documentation concerns in an ob-gyn setting. It frames the issue around medical necessity and audit risk.

  2. Electrodiagnostic testing mistakes

    Covers Medicare scrutiny of electrodiagnostic testing billing and the relevance of urogynecology-related testing services. It highlights the general need to align claims with coverage and clinical documentation.

  3. Imaging services advice

    Summarizes the Work Plan’s attention to imaging payment patterns and practice expense concerns. It also addresses the importance of supporting ultrasound services with clinical indications.

  4. Laboratory test inquiries

    Describes Medicare’s interest in laboratory test billing characteristics and possible questionable billing patterns. The section focuses on how lab ordering and utilization can draw review.

  5. Physician and supplier problem area

    Explains Medicare’s review of physician and supplier participation, claim assignment, and beneficiary billing concerns. The section places the topic in the context of Part B participation requirements.

  6. Payments for outpatient drugs and administration of the drugs

    Covers Medicare scrutiny of outpatient drug payment issues and administration billing, with attention to services often associated with oncology-related care. It points readers to broader Medicare claims-processing guidance.

What You Will Learn

  • Which general Medicare Part B service categories were highlighted in the 2014 OIG Work Plan
  • Why documentation and medical necessity are central themes in imaging and testing reviews
  • How ob-gyn and related practices may encounter scrutiny in laboratory, supplier, and drug billing areas
  • What types of Medicare policy references are discussed in connection with compliance review
  • How the article frames audit risk for practices that bill higher-volume or higher-cost services

Who Should Read This

  • Ob-gyn physicians
  • Urogynecology practices
  • Gynecologic oncology practices
  • Medical coders
  • Billing staff
  • Practice managers
  • Compliance personnel

Codes Discussed


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