Oncology & Hematology Coding Alert

Question: What's in the OIG's 2007 Work Plan that will effect oncology practices?

North Carolina Subscriber Answer: The 2007 Office of Inspector General (OIG) Work Plan offers fair warning that it will scrutinize advanced imaging services in physician offices.
 
The OIG will look at how these services have grown and examine billing patterns in certain areas and practice settings. The outcome could affect the growth of imaging services by non-radiologists.

The OIG will also be looking at Medicare Part B drug payment, including oral antiemetics and intravenous immune globulin (IVIG). Remember: Medicare covers certain oral antiemetics when they are a full therapeutic replacement for the intravenous antiemetic that you would have otherwise administered immediately before or within 48 hours after chemotherapy treatment.

The IVIG scrutiny will include looking at current market prices as well as product availability. Note: CMS plans to continue paying a -preadministration fee- for IVIG to help doctors cope with shortages
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Other areas the OIG will examine include:

- Incident-to services

- Place of service

- E/M during the global surgery period. You can see the plan on the Web at http://oig.hhs.gov/publications/docs/workplan/2007/Work%20Plan%202007.pdf.