Part B Insider (Multispecialty) Coding Alert
E/M Upcoding Charge Garners Hefty Settlement for Physician Practice
PDF
A recent Department of Justice (DOJ) settlement shows that the feds take overbilling on E/M services claims very seriously. El Paso Ear, Nose & Throat Associates (EPENT) settled its alleged False Claims Act (FCA) violations for purportedly submitting upcoded evaluation and management (E/M) services claims to Medicare and other federal health programs, a DOJ release says. EPENT agreed to pay DOJ $750,000 to settle the FCA violations. “Providers who line their pockets by over-billing for medical care increase medical costs for all of us and drain critical funds from Medicare and other government health programs,” warns U.S. Attorney Ashley C. Hoff in the DOJ release. “We will continue to hold accountable medical professionals who undermine our healthcare system by over-billing for care.”
Related Articles
Part B Insider (Multispecialty) Coding Alert
- Enforcement:
Feds Target COVID Fraud in New Report
Caution: Expect scrutiny to only get more intense. If you thought the feds would put [...] - Here’s a Breakdown of the Latest Enforcement Numbers
Compare and contrast the last two reporting period stats during COVID. Despite being in the [...] - National Correct Coding Initiative:
Master NCCI PTP Edits With 4 Handy Tips
Caution: Take care when using a modifier to break an edit. When you submit myriad [...] - Part B Coding Coach:
Boost Non-Invasive Vascular Study Coding With This Insight
Tip: Review whether the code is bilateral or unilateral. If non-invasive vascular diagnostic study claims [...] - Clip And Save:
Pocket This POS Coding List
Tip: Check the small print on definitions to sidestep confusion. Correct place of service (POS) [...] - Physician Notes:
E/M Upcoding Charge Garners Hefty Settlement for Physician Practice
A recent Department of Justice (DOJ) settlement shows that the feds take overbilling on E/M [...] - Physician Notes:
ACA Stands Strong in Latest Challenge in the Supreme Court
In its third legal go-round, Obamacare triumphs again after the U.S. Supreme Court confirms the [...] - Physician Notes:
CMS Bumps Up Payment for At-Home COVID Shots
You can expect a little more money in your pocket for at-home COVID-19 vaccination administration. [...]