tci Medicare Compliance & Reimbursement - 2012 Issue 11

Compliance: OIG to Send CMS Names of 1,700 Docs Who Overbilled High-Level E/M Codes

Frequency of reporting 99214 and 99215 increased 17 percent over 9-year period.If you examine your practice's E/M trend line, does your frequency of reporting high-level E/M codes increase dramatically over the years? If so, you should determine the reasons why, before your MAC begins forcing you to make that determination.A recent OIG study found that physicians increased their billing of higher-level E/M codes across all categories (inpatient, outpatient, etc.) between 2001 and 2010. In fact, the OIG sent CMS a list of 1,700 physicians who were identified as "consistently billing higher-level E/M codes in 2010...

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