Medicare Compliance & Reimbursement - 2011 Issue 16
Compliance: OIG: Physician Orders Missing for 9 Percent of Emergency Dept. X-Ray Interpretations
Subscribe or sign in to view the full article.
Article Overview
This compliance-focused article reviews an OIG report on Medicare Part B payments for diagnostic radiology services in emergency departments. It explains the broad categories of documentation and timing problems found in the audit, highlights the role of CMS and Medicare contractors, and signals why hospitals, emergency departments, radiology departments, and auditors should pay attention to ED imaging claim documentation.
Why This Topic Matters
The article matters because it describes a federal audit showing widespread documentation and timing issues in ED diagnostic radiology claims, which can trigger payment recoupment, closer contractor scrutiny, and internal compliance review. It is relevant for organizations that bill or audit emergency department imaging services and need to understand the general compliance risks discussed in the OIG findings.
What You Will Learn
- What the OIG reviewed in its audit of emergency department radiology claims
- The main categories of documentation and payment issues identified in ED imaging claims
- How CMS and Medicare contractor guidance is discussed in relation to interpretation timing
- Why emergency department and radiology compliance teams may face increased scrutiny
- What broad documentation practices are emphasized for ED diagnostic radiology billing
Who Should Read This
- Emergency department billing staff
- Radiology department coders and billers
- Hospital compliance officers
- Medical auditors
- Revenue cycle professionals
- Healthcare administrators
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com