Compliance: OIG to Focus on Incident-to Services, Ultrasounds, Unlisted Procedures, And More in 2009

Why This Topic Matters

The article helps compliance and coding professionals anticipate areas of government review and assess whether their documentation and billing practices may warrant closer internal attention.

Article Sections

1. Unlisted Procedures Under Fire

   Discusses the Work Plan’s attention to procedure coding for services that are not listed in HCPCS and the broader compliance concern around how those services are reported.

2. Modifier GY On Hot Seat

   Covers the Work Plan’s review of modifier use on claims involving services not covered by Medicare, along with related compliance and beneficiary-notification context.

3. OIG Reviews Ultrasounds

   Summarizes planned OIG scrutiny of high-volume ultrasound billing and the agency’s interest in medical necessity and utilization patterns.

4. Incident-to on the Radar

   Addresses the OIG’s continued focus on incident-to services and the documentation and practitioner-qualification issues associated with that area.