Compliance: OIG Sets Sights on E/M Services, Place of Service Coding

Why This Topic Matters

These audit priorities can affect claim payment, documentation integrity, and compliance risk across multiple common billing workflows. Understanding the topics highlighted in the Work Plan helps practices focus review efforts on areas likely to attract payer scrutiny.

Article Sections

1. E/M Services Under Fire

   Discusses the OIG’s focus on evaluation and management documentation and related medical record vulnerability concerns. It also addresses the broader compliance significance of documentation consistency and uniqueness.

2. Differentiate ‘AA’ From ‘QK’ Modifier

   Covers the OIG’s attention to anesthesia reporting and modifier-related payment accuracy. The section explains the general compliance context for personally performed and medically directed anesthesia services.

3. Know Your Place of Service

   Reviews the article’s discussion of place of service coding and the risk of misidentifying where a service was performed. It emphasizes the Medicare payment impact of accurate location reporting.