The OIG has issued the June update to their Workplan. The newest update contains a couple of notable additions for providers.
Care Planning Services (CPT 99497 and 99498) has been
- The OIG will be reviewing these services to determine if the documentation supports a face to face encounter occured and the time spent performing care planning services. Historically, these services have been associated with a high payment error rate.
lab testing (CPT 86328, 86769,
87635) has also been added.
- The OIG will specifically target providers with high billing utilization patterns for audits to determine whether services were actually performed and clinically appropriate.
recommend providers review the Workplan in its entirety and conduct internal
auditing and monitoring of services included in the Workplan as well as provide
staff education and training as needed to ensure proper billing.
Guidance on Advanced Care Planning Services is located at: https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/downloads/advancecareplanning.pdf
The Workplan is located at: https://oig.hhs.gov/reports-and-publications/workplan/updates.asp