Part B Insider (Multispecialty) Coding Alert

Physician Note:

OIG Audit Finds Only 15 Percent of E/Ms With Eye Injections Were Properly Billed

Plus: HIPAA slip costs director his job.

Tacking an E/M code onto your eye injections as a standard billing strategy? Not so fast. The OIG is looking at these transactions and does not like what it sees.

The new OIG report, released last week, indicates that for 85 services out of 100 that the OIG sampled, a particular hospital incorrectly billed E/M services during outpatient eye injections, creating overpayments of $8,100. When extrapolated to all of that hospital's eye injection claims, the hospital collected $211,000 more than it should have over a two-year period.

In most cases, the OIG simply found that the physicians didn't perform E/M services that were significant and separately identifiable from the injections. Instead, the OIG determined that any evaluation performed was "part of the usual preoperative work of the eye injection procedure," the report noted.

To read the complete report, visit http://oig.hhs.gov/oas/reports/region1/11100515.pdf.