Medicare contractors overpaid physicians an estimated $13.8 million for claims with the incorrect place-of-service code during calendar year 2007, the HHS Office of Inspector General (OIG) says in an audit report (A-01-09-00503) posted Aug. 13, 2010.

Medicare reimburses physicians more for certain services they perform in offices, urgent care centers or independent clinics, but pays the overhead to facilities when physicians work in hospital outpatient departments or ambulatory surgical centers (ASCs), OIG explains. Out of 100 sampled services, OIG found that physicians incorrectly coded the claims for 90 services by using nonfacility place-of-service codes for services that were actually performed in hospital outpatient departments or ASCs. The coding errors in the samples resulted in overpayments of $4,710, and OIG estimates that contractors nationwide overpaid physicians $13.8 million. OIG says CMS should (1) recover the $4,710; (2) reopen the claims associated with nonsampled services and work with physicians to recover any overpayments; (3) continue efforts to strengthen the education process and tell physicians and their billing agents the importance of correctly coding the place of service; and (4) work with program safeguard contractors and coordinate data matches with other Medicare contractors. CMS agreed with the findings and recommendations. To read more, go to Government Resources; click on “OIG Audit Reports.”

Reprinted from the Aug. 23, 2010, issue of REPORT ON MEDICARE COMPLIANCE

Additional government news appears in AIS’s HEALTH BUSINESS DAILY

Source: www.AISHealth.com, Government News of the Week, Aug. 23, 2010.

Posted by permission of Atlantic Information Services, Inc.