Outpatient Facility Coding Alert - 2007 Issue 39
COMPLIANCE: Collecting From Both Part A and B Isn't Twice as Nice to the OIG
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Article Overview
This article explains a Medicare compliance issue involving laboratory services furnished during inpatient stays and why payment coordination between Part A and Part B matters. It summarizes an OIG audit of carrier payments, the types of lab services implicated, and the responsibilities of laboratories, hospitals, and Medicare contractors in preventing duplicate reimbursement. The piece is aimed at laboratory billing staff, compliance teams, and healthcare revenue cycle professionals who need to understand inpatient-related lab billing oversight.
Why This Topic Matters
The topic matters because improper billing for inpatient lab services can lead to duplicate payment, audit findings, and repayment exposure. It also highlights the need for internal controls and contractor coordination in Medicare billing workflows.
What You Will Learn
- How Medicare payment for inpatient-related laboratory services is coordinated
- Why duplicate payment issues can arise between Part A and Part B
- What kinds of lab services are discussed in the context of inpatient stays
- Why compliance controls and billing checks are important in lab billing operations
- How OIG audit activity can affect laboratory and hospital billing practices
Who Should Read This
- Laboratory billing staff
- Compliance officers
- Revenue cycle professionals
- Hospital billing teams
- Medical laboratory managers
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