Office of Inspector General (OIG) releases 2009 Workplan

The 2009 OIG Workplan is out and available.

Items of interest to physicians include:

• Place 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)

The OIG will also review Services Performed by Non Physicians under “Incident To” Arrangements, and Medicare Billings with Modify GY (statutorily excluded services)