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.