Compliance: Steer Clear Of These 7 Questionable Billing Practices

Why This Topic Matters

Electrodiagnostic testing is an area where billing patterns, documentation, and contractor-specific coverage rules can affect compliance risk and claim payment. Understanding the article helps practices identify the kinds of issues that may lead to scrutiny without relying on the premium article for the underlying details.

Article Sections

1. Learn What Led to the Investigation

   Explains the broad Medicare spending trends that prompted OIG attention and the general context for the investigation. It also introduces the overall program integrity focus related to electrodiagnostic testing.

2. Guard Against Questionable Billing Practices

   Summarizes categories of billing patterns that were identified for closer review and places them in a compliance context. The section also notes specialty comparisons and measurement approaches used in the report.

3. Know What Your MAC Expects

   Describes the role of Medicare Administrative Contractors and Local Coverage Determinations in shaping local coverage and utilization guidance. It also covers the general relationship between local policies, claim review, and contractor oversight.