Anesthesia Coding Alert

Don’t set yourself up to be a DOJ target.

If you thought still dealing with a pandemic would slow investigations by the Department of Justice (DOJ), think again. Data from January reports shows that the feds are still on the lookout for physicians involved with Medicare fraud schemes —and they’re still holding those providers accountable.

Case in point: In Tennessee, three Nashville-based providers settled False Claims Act (FCA) violations for fraudulent acupuncture claims. James P. Anderson, MD, owner of Affiliated Neurologists, PLC; Charles F. Spencer, DC, owner of Total Family Physicians Center PLLC d/b/a Total Family Health & Wellness; and Mitchell P. Shea, DC, owner of Chiro2Med of Tennessee P.C., agreed to pay $1.72 million to “resolve liability under the False Claims Act for the alleged improper billing for electro-acupuncture using a peri-auricular stimulation device known as ‘P-Stim,’” a DOJ release said.

Between May 2016 and November 2018, the three practitioners billed Medicare and TennCare for the acupuncture devices using HCPCS Level II code L8679 (Implantable neurostimulator, pulse generator, any type) — but the providers didn’t surgically implant neurostimulators, DOJ noted. The P-Stim devices the providers attached to patients’ ears with adhesive are not reimbursed by Medicare or TennCare.

Heed their warning: “Physicians that perform illegal and baseless procedures violate the sanctity of the doctor-patient relationship,” warned U.S. Attorney Chapa Lopez in the release related to a separate case in Florida.