OIG Work Plan Update: Lab Tests During COVID

In their most recent Work Plan update, the OIG has announced they will conduct a series of audits for Medicare Part B laboratory services provided during the COVID-19 pandemic. 

The OIG did a preliminary analysis of lab testing which showed a significant decrease in the number of non-COVID lab tests billed during the pandemic.  They also know that many independent labs have encountered challenges in providing COVID testing.  Due to these findings, the OIG will initially focus on the effect the pandemic has had on non-COVID-19 testing.  They will also conduct audits on aberrant billing of COVID-19 testing during the pandemic.

We recommend providers perform audits of COVID-19 testing to ensure compliance with reporting guidelines and to prevent overpayments. 

Additional information regarding appropriate documentation and coding of COVID-19 laboratory testing can be found here: https://www.ama-assn.org/practice-management/cpt/covid-19-cpt-coding-and-guidance

The OIG Work Plan is available at: https://oig.hhs.gov/reports-and-publications/workplan/

HBE’s team of coding and compliance experts is available to assist you with external reviews of your documentation, coding and reimbursement as well as providing customized education and training for your staff.  We are also available to provide assistance with conducting risk assessments, internal investigations and policy and procedure development.  

DISCLAIMER:  This newsletter contains only summary information and highlights; it should be read in conjunction with the full article or document provided as a link.  Any advice or recommendations are general and specific questions should be directed to professional counsel.

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