tci Part B Insider - 2009 Issue 25

COMPLIANCE: 20 Percent of Ultrasound Claims 'Raise Concerns,' OIG Says

Plus: The OIG identified 20 counties it classifies as "high use" for ultrasounds. The OIG is watching ultrasound claims -- and it doesn't like what it sees. An OIG audit of ultrasound services billed in 2007 found that nearly one in five ultrasound claims "had characteristics that raise concerns about whether the claims are appropriate," according to a July 2009 audit report entitled "Medicare Part B Billing for Ultrasound." The most common error: 17 percent of Part B ultrasound claims billed in 2007 lacked prior service claims by the ordering physician, the OIG indicated. What this means:...

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