tci Part B Insider - 2012 Issue 35

Compliance: OIG to Focus on E/M, Incident-to, and Global Modifiers in 2013

Plus: You'll also see extra scrutiny on anesthesia and ophthalmology claims, among others. The HHS Office of Inspector General (OIG) has some big plans next year for reviewing Part B claims, and they span the whole spectrum of issues, according to the OIG's 2013 Work Plan, released on Oct. 2. Get to know these hot buttons before you press them. 1. Potentially Inappropriate E/M Payments and 'Identical Documentation.' The OIG intends to go back in time--all the way to 2010, to be exact, when reviewing E/M claims. "We will determine the extent to which CMS made potentially inappropriate...

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