CONSULTATIONS: Prepare For A New Crackdown On Consult Billing

Why This Topic Matters

Consultation billing is a frequent audit focus, and the article summarizes why improper reporting can create significant compliance risk for providers. It helps readers identify the general categories of issues being reviewed so they can assess whether their own billing practices warrant closer review.

Article Sections

1. OIG findings on consultation billing

   Summarizes the scope of the audit findings and the extent of consultation billing errors identified in Medicare claims. The section frames the overall compliance concerns that prompted the article.

2. Common billing and documentation problems

   Reviews the broad categories of issues cited in the report, including classification concerns, documentation gaps, and situations where consultation billing was not supported as reported. It also notes patterns seen across different consultation levels.

3. Recommended response and CPT update context

   Describes the general compliance response suggested in the article and references a CPT-related update affecting consultation reporting. The section places the report findings in the context of coding education and code set changes.