Part B Insider (Multispecialty) Coding Alert
Consults, NPP Billing Lead To Big Payouts
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Three physicians agreed to repay $1 million after they allegedly billed for services that nurse practitioners and physician assistants provided. The physicians billed for the services as though they provided them personally.
Also, a Pennsylvania cardiologist repaid $435,000 after the government claimed he was billing consults that didn't meet the definition of a consult, or lacked proper documentation. The feds also claimed he billed for evaluation & management services that were already covered in his payment for nuclear stress testing.
Beware: Those are just two of the horror stories in the latest semiannual report from the HHS Office of Inspector General. The OIG is still looking over your shoulder on incident-to billing, consults and incorrect place of service (POS).
Just ask the Ohio pain management physician who received a life prison sentence, plus $14.3 million repayment, after a jury found he performed unnecessary--and painful--procedures on patients, in exchange for narcotic prescriptions.
Part B Insider (Multispecialty) Coding Alert
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