Outpatient Facility Coding Alert - 2007 Issue 33
IMAGING: Imagine A Crackdown On Diagnostic Imaging Next Year
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Article Overview
This premium article reviews anticipated federal scrutiny of diagnostic imaging and adjacent physician billing areas. It summarizes the kinds of studies and oversight efforts being considered by the OIG and MedPAC, including imaging utilization, physician ownership arrangements, incident-to billing, polysomnography, reassignment of benefits, place-of-service reporting, and other service-payment questions. It is aimed at coding, billing, compliance, and practice management professionals who track Medicare oversight trends and policy developments.
Why This Topic Matters
Changes in oversight and audit focus can affect documentation, billing compliance, physician relationships, and practice operations. Readers can use this update to gauge which service areas may face increased review and to stay informed about federal payment integrity priorities.
Article Sections
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Diagnostic imaging oversight trends
The opening discussion focuses on federal attention to imaging utilization and physician ownership arrangements. It frames the broader policy environment surrounding Medicare oversight of imaging services.
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Planned OIG imaging studies
This section outlines several Office of Inspector General review topics related to imaging use patterns and physician business relationships. It places those studies in the context of broader payment integrity monitoring.
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MedPAC concerns and related service areas
The article then summarizes Medicare Payment Advisory Commission interest in physician incentives and additional ownership-related service areas. It also notes concerns about rising imaging costs.
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Other OIG Work Plan items
The final discussion reviews additional OIG work plan topics beyond imaging. It mentions several physician billing and reporting areas that may receive further scrutiny.
What You Will Learn
- Which federal agencies are examining imaging utilization and physician-related billing issues
- What broad imaging and physician service topics appear in upcoming oversight reviews
- Why Medicare payment integrity and ownership arrangements are being highlighted
- Which additional billing and reporting areas are included in OIG planning
Who Should Read This
- Medical coders
- Billing specialists
- Compliance professionals
- Practice managers
- Physician group administrators
- Healthcare consultants
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