OIG 2011 Work Plan and Evaluation & Management Coding

The OIG has once again sets its sights on new targets in the coming year and one

thing that's for sure is that the feds will be checking your E/M documentation strictly.

The OIG published its 2011 Work Plan on October 1 this year. The plan outlines the areas that the Office of Audit Services, Office of Evaluations and Inspections, Office of Counsel to the Inspector General, Office of Investigations, Office of Management and Policy, and Immediate Office of the Inspector General will address during the 2011 fiscal year. When the OIG targets an issue in its Work Plan, you can anticipate the agency to review and audit sample claims of those services.

"The work plan describes the specific audits and evaluations that we have underway or intend to come up with in the coming year considering our discretionary and statutorily mandated resources," the document reads.

On the agenda for the coming year, the OIG has indicated its investigators will review the extent of potentially inappropriate payments for E/M services and the consistency of E/M medical review determinations. The OIG also plans to find out whether payments for E/M services performed during the global periods of other procedures were proper.

In addition to it, the OIG will scrutinize Medicare payments for Part B imaging services, outpatient physical therapy services, sleep testing, diagnostic tests, and claims with modifier GY on them.

The OIG also intends to 'review Medicare payments for observation services provided during outpatient visits in hospitals' to evaluate whether hospitals' use of observation services affects Medicare beneficiaries' care.

To keep your compliance plan up to date, sign up for a medical coding guide like Supercoder!

OIG 2011 Work Plan and Evaluation & Management Coding

By: James Smith

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