tci Part B Insider - 2008 Issue 6

COMPLIANCE: Watch Those Big-Ticket Claims or the OIG Will Watch for You

Ever wondered why MUEs matter? Several recent audits show you If big-ticket claims are your practice's bread and butter, keep in mind that the OIG is watching carefully.A string of recent OIG audits shows just how attuned the agency is to high-dollar errors, and demonstrates a possible reason why the Correct Coding Initative's (CCI-s) new medically unlikely edits (MUEs) were imposed.For example, according to the OIG's Jan. 4 audit report of Group Health Inc. (GHI), a Part B payer in Queens County, N.Y., the agency reviewed 14 -high-dollar- payments to providers (claims resulting in payments of...

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