tci Medicare Compliance & Reimbursement - 2011 Issue 7

Compliance: OIG Revisits Recommendation to Adjust Eye Global Surgery Fees

OIG discovered inconsistent billing for global eye surgery and believes adjustments could save CMS $97.6 million. When the OIG talks not everyone listens, according to a new report. The OIG makes hundreds of recommendations each year, advising practices and carriers to tighten up documentation, correct their modifier use, or implement other programs. On March 16, the OIG released its "Compendium of Unimplemented Recommendations," which revealed that practices and facilities have ignored many OIG suggestions.Case in point: In 2005, the OIG found that global surgery fees for eye surgeries "did not reflect the number of E/M Services...

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