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OIG Report on E/M Services

On May 29, 2014, the Office of Inspector General (OIG) released a detailed report on improper payments made in 2010 for evaluation and management services. The report titled “Improper Payments for Evaluation and Management Services Cost Medicare Billions in 2010” reveals improper payments of $6.7 billion. The report contains an error rate of 42% for E/M claims incorrectly coded or lacking documentation to support the service.

A full copy of the report can be found at: http://oig.hhs.gov/oei/reports/oei-04-10-00181.pdf

The annual OIG Work Plan has, for the past several years, included an action item of inappropriate payments for E/M services. This report confirms the OIG’s concerns in seeking out these incorrect payments. The May 29 report encourages Medicare contractors to review E/M services and follow up on claims paid in error.

Corcoran Consulting Group has numerous resources available to assist in reviewing your E/M services and training on the complex E/M coding system. We address both overcoding and undercoding. Contact us for additional information at 800-399-6565.

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