tci Part B Insider - 2009 Issue 28

INCIDENT TO: OIG Finds Alarming Error Rates Among Incident To Claims

OIG wants practices to append a special modifier to denote incident to services, but CMS isn't interested. The OIG is fed up with incident to errors, and its auditors want CMS to take action that could turn your billing and coding upside-down. On Aug. 5, the OIG released its report, "Prevalence and Qualifications of Nonphysicians Who Performed Medicare Physician Services," which noted that unqualified non-physician practitioners (NPPs) performed 21 percent of incident to services. "In the first three months of 2007, Medicare allowed $12.6 million for approximately 210,000 services performed by unqualified nonphysicians," the report...

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