OIG finds most physicians' Medicare coding OK
The Office of the Inspector General gave the Academy some welcome news last month: The vast majority of physicians are correctly coding for Medicare reimbursement.
When there's a coding problem, it's almost always because the physician has given little or no explanation for the coding. For example, the physician may simply note that a patient is "stable" while coding the visit as very complex.
Several AAFP and OIG staff members met June 10 to discuss the OIG chief financial officer's audit of the Health Care Financing Admin- istration's finances and how Medicare carriers process claims. The audit did not aim to detect fraud but to identify problems in the processing system.
One result of the audit: The OIG will keep urging carriers to interpret HCFA's instructions uniformly, instead of having variation in how carriers implement rules.
If you know examples of wide variations in how carriers follow HCFA's instructions, contact Michele Johnson in the Academy's Washington Office at (888) 794-7481.
FP Report is published by the AAFP News Department. Copyright © 1998 by American Academy of Family Physicians.