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Medicare Compliance & Reimbursement

Global Surgery Package Pay for Cardiovascular, Musculoskeletal Surgeons Could Be Slashed

Published on Sun Jun 03, 2012

Latest OIG reports indicate that these specialists aren't performing all included E/Ms.You probably know that global surgical fees include a set number of E/M services that are bundled into each surgery. But what you may not know is that the government keeps tabs on how many of those E/Ms you actually perform -- and if you don't provide the E/M services, Medicare can cut them from the package -- and decrease your surgical fees.Two recent OIG audits reveal that cardiovascular and musculoskeletal surgeons are vastly underperforming the E/M services included in surgical packages, but are collecting the entire global fee. This means that Medicare is overpaying these doctors for their surgeries.Cardiovascular surgery: The OIG sampled 300 global surgeries and found that in 132 of them, the physicians provided fewer E/M services than were included in the global package, meaning that they technically collected more than they should have for the service.On the [...]
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