Medicare Compliance & Reimbursement

Watch out for improper modifier use and incident-to billing in 2013.The Health and Human Services Office of Inspector General (OIG) released the 2013 Work Plan in October and it spans the whole spectrum of issues that the OIG has found to be hotspots. Take a look at some of the areas under the OIG microscope so that your practice can straighten out any problems before the auditors come knocking.1. Potentially Inappropriate E/M Payments and 'Identical Documentation.' The OIG intends to go back in time -- all the way to 2010, to be exact, when reviewing E/M claims. "We will determine the extent to which CMS made potentially inappropriate payments for E/M services in 2010 and the consistency of E/M medical review determinations," the Work Plan states. The OIG also plans to review multiple E/M notes for each provider to determine whether EHR errors are creating cloned notes across services.Bottom line: If a [...]