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Medicare Compliance & Reimbursement

FACET JOINT BILLING:

Physicians Overbilled Facet Joint Injections by $96 Million, OIG Says

Published on Mon Jan 26, 2009

CMS warns MACs to be on the lookout for improperly billed injections. Making a $50 error might not seem like a big deal -- but add all of those errors together and you could put a giant dent in Medicare's injection payment structure. That's the word from CMS transmittal 440, issued Feb. 6. The OIG examined facet joint injections that practices performed in 2006 in their offices, and discovered an outrageous 63 percent error rate, which racked up $96 million in improper payments for these services. Due to the OIG's findings, CMS advises its carriers to strengthen safeguards to prevent improper facet joint injection billing. Follow our experts' tips to ensure that you stay out of the OIG's cross-hairs when you bill these procedures. The challenge: One potential snag in facet joint injection coding is whether to report multiple units of a code when the doctor performs more than one [...]
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