tci Medicare Compliance & Reimbursement - 2009 Issue 4

FACET JOINT BILLING: Physicians Overbilled Facet Joint Injections by $96 Million, OIG Says

CMS warns MACs to be on the lookout for improperly billed injections. Making a $50 error might not seem like a big deal -- but add all of those errors together and you could put a giant dent in Medicare's injection payment structure. That's the word from CMS transmittal 440, issued Feb. 6. The OIG examined facet joint injections that practices performed in 2006 in their offices, and discovered an outrageous 63 percent error rate, which racked up $96 million in improper payments for these services. Due to the OIG's findings, CMS advises its carriers to strengthen safeguards to...

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