Part B Insider (Multispecialty) Coding Alert

UPCODING:

E/M Upcoding Leads to $1.36 Million Payout

Here's one more reason to be sure your evaluation and management coding practices are up to snuff: The ex-chief financial officer of a health-care management and billing company just scored a victory in a whistle-blower suit against his former employer and two physician practices.

Medical groups Health Texas Medical Group and Solomon Anthony Clinic, along with management company Primary CareNet of Texas, will pay $1.36 million to settle the qui tam suit, according to the U.S. Department of Justice. The three San Antonio, Texas, organizations are affiliates of Christus Health of Houston

Whistleblower Timothy Ohman's lawsuit accused the three of improperly billing Medicare and Medicaid by upcoding evaluation and management services.

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