Industry Notes: OIG Doubles Down on Dx Miscoding Mishaps in Part C
Expect greater scrutiny as feds look at chart review results.
Evidenced by numerous reports, Work Plan additions, and enforcement activity, Medicare Advantage (MA) organizations have been on the HHS Office of Inspector General’s (OIG’s) radar for some time. And now the national watchdog has added another Part C concern to its watchlist.
Details: In Work Plan item WA-23-0037 (W-00-23-35903), OIG plans to home in on MA organizations’ unlinked chart reviews, looking specifically at risk adjustment issues in relation to diagnosis codes. The problem stems from the Centers for Medicare & Medicaid Services (CMS) using this information to...
To read the full article, sign in and subscribe to tci Medicare Compliance & Reimbursement.
Keep pace with evolving Medicare regulations — and onboard your team — with timely analysis of critical updates interpreted in an easy-to-follow, easy-to-apply format. Your subscription to TCI's Medicare Compliance & Reimbursement Alert will equip you to navigate code and guideline changes, CCI edits, and revisions to modifiers, payer policies, the fee schedule, OIG target areas, and more.
Current newsletters added each month
Fully searchable archives - over 4200 articles
ALL years/issues back to 2003 organized by year and issue
Codes mentioned in articles are linked to Code Information pages
Code Information pages link back to related articles
Access to this feature is available in the following products: