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OIG: Incorrect coding on physician claims leads to $33.4M in Medicare overpayments: 5 quick facts

The Office of the Inspector General has released the Incorrect place-of-service claims resulted in potential Medicare overpayments costing millions report. Here are five quick facts to know.

1. The report covers claims covering services provided from January 2010 to September 2012.

2. During those years, Medicare contractors made $33.4 million in overpayments, due to physicians not correctly coding the place of service on physician claims.

3. The $33.4 million in overpayments for incorrectly coded services included:

•    $18.2 million in potential overpayments for services of unselected hospital outpatient location-based claims
•    $7.3 million in potential overpayments for services performed in ambulatory surgery centers
•    $7.1 million in potential overpayments for services performed in hospital outpatient locations
•    $800,000 in potential overpayments for services of 33 selected physician who claim they were not responsible for the incorrect billing

4. A previous OIG report covering calendar years 2005 through 2009 found $62.7 million in overpayments for physician services.

5. The potential overpayments uncovered in the 2015 report are attributed to internal physician billing control weaknesses and insufficient post-payment reviews at the Medicare contractor level.

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