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Ophthalmology and Optometry Coding Alert

Compliance:

OIG to Focus on E/M, Incident-To, and Global Modifiers in 2013

Published on Tue Oct 09, 2012

Plus: You'll also see extra scrutiny on ophthalmology claims, among others. The HHS Office of Inspector General (OIG) has some big plans next year for reviewing Part B claims, and they span the whole spectrum of issues, according to the OIG's 2013 Work Plan, released on Oct. 2. Get to know these hot buttons before you press them. 1. Potentially inappropriate E/M payments and 'identical documentation.' The OIG intends to go back in time -- all the way to 2010, to be exact, when reviewing E/M claims. "We will determine the extent to which CMS made potentially inappropriate payments for E/M services in 2010 and the consistency of E/M medical review determinations," the Work Plan states. The OIG also plans to review multiple E/M notes for each provider to determine whether EHR errors are creating cloned notes across services.Bottom line: If a physician is documenting each patient identically rather than documenting [...]
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