Office of the Inspector General (OIG) Posts Report, Medicare Payments for Facet Joint Injection Services

On September 17, 2008, the Office of Inspector General (OIG) posted a report (OEI-05-07-00200) entitled, “Medicare Payments for Facet Joint Injection Services.” The most significant finding stated in the report is that an estimated 63% of facet joint injection services allowed by Medicare in 2006 did not meet Medicare program requirements, which resulted in approximately $96 million in improper payments. Medicare payments for facets have more than doubled between 2003 and 2006. The OIG based these estimates on evaluation of 646 claims for correct coding and medical necessity. The claims error rate for facet injections is much higher than reported for most Medicare services. This report will serve as the topic of the upcoming December Practice Management column.

In the meantime, you can access the full report.

If you have any comments or feedback on the report, please feel free to email Jason Byrd at [email protected].