The Office of Inspector General has estimated that Medicare contractors nationwide overpaid physicians roughly $28.8 million combined in 2008 and 2009 for incorrectly coded services, according to two OIG reports.
One OIG report (pdf) found that physicians correctly coded claims on only 17 of the 100 services sampled for 2009, totaling $9.5 million in overpayments for that calendar year. However, physicians incorrectly coded claims of the 83 sampled services by using non-facility place-of-service codes for services that were actually performed in hospital outpatient departments or ambulatory surgical centers.
The other OIG report (pdf) found that in 2008, physicians correctly coded claims on only 11 of the 100 services sampled for 2008, totaling $19.3 million in overpayments for that calendar year.
North Carolina's Baptist Hospital Overcharges State Health Plan $1.34M
How to Navigate the RAC Appeals Process
One OIG report (pdf) found that physicians correctly coded claims on only 17 of the 100 services sampled for 2009, totaling $9.5 million in overpayments for that calendar year. However, physicians incorrectly coded claims of the 83 sampled services by using non-facility place-of-service codes for services that were actually performed in hospital outpatient departments or ambulatory surgical centers.
The other OIG report (pdf) found that in 2008, physicians correctly coded claims on only 11 of the 100 services sampled for 2008, totaling $19.3 million in overpayments for that calendar year.
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How to Navigate the RAC Appeals Process