tci Medicare Compliance & Reimbursement - 2012 Issue 12

Industry Notes: OIG Audit Finds Only 15 Percent of E/Ms With Eye Injections Were Properly Billed

Tacking an E/M code onto your eye injections as a standard billing strategy? Not so fast. The OIG is looking at these transactions and does not like what it sees.The new OIG report, released last week, indicates that for 85 services out of 100 that the OIG sampled, a particular hospital incorrectly billed E/M services during outpatient eye injections, creating overpayments of $8,100. When extrapolated to all of that hospital's eye injection claims, the hospital collected $211,000 more than it should have over a two-year period.In most cases, the OIG simply found that the physicians...

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