tci Medicare Compliance & Reimbursement - 2007 Issue 9

HOSPITALS: Prepare For More Scrutiny Of Your Outpatient Billing

OIG work plan targets inpatient dialysis admissions--and much more.Now's the time to be certain you're billing correctly for dialysis services. The HHS Office of Inspector General (OIG) has announced plans to determine whether payments were made for inpatient admissions for dialysis services when the physicians' orders stated the level of care as admission to observation status. In conjunction with medical reviews conducted by fiscal intermediaries (FI), the OIG has found that some hospitals admitted patients for dialysis treatment, which lasted from 24 to 48 hours, but medical reviewers determined that the stays were for observation rather than treatment...

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