OIG Workplan

Did you know the following physician issues were included on the OIG (Office of Inspector General) work plan?

  1. Billing Service Companies – Review of incentives to up code and over bill.
  2. 99374 – 99380 – Care Plan Oversight – I’d see if any of your docs are billing this.  There are certain criteria that must be met which is the review underway.
  3. Physician Pathology Services – reviewing the relationship between the pathologist and the ordering physician.
  4. E&M Coding – Determining if outliers are being appropriately reviewed.
  5. Use of 25 and 59 Modifiers – Review of appropriateness
  6. Provider Based entities – Review of site of service for entieis that may be billing as office but should be facility billing.

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Reed Tinsley, CPA