Part B Insider (Multispecialty) Coding Alert

Consults, Drugs Still On OIG Radar

The OIG also recapped some of its most important reports from the past year:

Consults: Medicare spent $1.1 billion on services that physicians wrongly billed as consults, the OIG said. Almost all top-level consults (95 percent) were wrongly coded, the OIG found.

Drugs: The OIG also looked into payments for Part B drugs, and found that Medicare could be saving between $64 million and $164 million per year if it used other drug prices in the marketplace to set payment amounts. The OIG found that CMS didn't calculate the number of units of a drug sold in a consistent way, which led to some drugs being overpriced or underpriced.

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