tci Part B Insider - 2012 Issue 17

Compliance: OIG to Send CMS Names of 1,700 Docs Who Overbilled High-Level E/M Codes

Frequency of reporting 99214 and 99215 increased 17 percent over 9-year period. If you examine your practice's E/M trend line, does your frequency of reporting high-level E/M codes increase dramatically over the years? If so, you should determine the reasons why, before your MAC begins forcing you to make that determination. A recent OIG study found that physicians increased their billing of higher-level E/M codes across all categories (inpatient, outpatient, etc.) between 2001 and 2010. In fact, the OIG sent CMS a list of 1,700 physicians who were identified as "consistently billing higher-level E/M codes in 2010...

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