Feds targeting doctors who miscode Medicare Part B place of service
8.13.2010
The Department of Health and Human Services' Office of the Inspector
General (HHS OIG) is recommending that Medicare officials crack down on
physicians who have incorrectly coded their Medicare claims for place of
service, after an OIG HHS report found that Medicare contractors
overpaid physicians $13.8 million for incorrectly coded services
provided during 2007. Medicare reimburses doctors at a higher rate when
services are preformed in their offices or other non-facility locations,
as compared to services performed in a hospital or other facility
setting, to account for overhead expenses.
According to the report, physicians correctly coded the claims for 10 of the 100 services sampled. However, physicians incorrectly coded the claims for 90 sampled services by using nonfacility place-of-service codes for services that were actually performed in hospital outpatient departments or freestanding ambulatory surgical centers. The incorrect coding resulted in overpayments totaling $4,710. Based on these sample results, the HHS OIG estimates that Medicare contractors nationwide overpaid physicians $13.8 million for incorrectly coded services provided in 2007.
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