October 29, 2008
Office of Inspector General (OIG) releases 2009 Workplan
The 2009 OIG Workplan is out and available.
Items of interest to physicians include:
of service errors – OIG will look at claims for services provided in
ASCs and Hospital Out-patient departments to confirm that the place of
service is properly reported.
- Patterns related to high
utilization of ultrasound services – OIG will review for medical
necessity. In areas with high use, OIG will examine service, provider
and beneficiary profiles.
- Medicare payments for unlisted codes
– OIG will review claims that report unlisted service codes to verify
that the service is not described with a code from the Healthcare
Common Procedure Coding System (HCPCS)
OIG will also review Services Performed by Non Physicians under
“Incident To” Arrangements, and Medicare Billings with Modify GY
(statutorily excluded services)