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Recently the AMCNO was pleased to participate in a Center for Medicare and
Medicaid Services (CMS) Region V Provider Update session. Facilitating the
meeting was Dr. Derek Robinson, Chief Medical Officer for CMS Region V.
Presenters were on hand from CMS, CGI (the RAC contractor for Ohio) CGS (the MAC
contractor for Ohio) and representatives from Medicare Advantage. Dr. Robinson
asked the AMCNO to make our members aware of the recent Office of the Inspector
General (OIG) report to CMS regarding place-of-service coding for physician
services processed by Medicare Part B contractors. The purpose of the OIG sample
audit was to determine whether physicians correctly coded nonfacility place of
service codes on selected Part B claims. The report found that a select sampling
of physicians did not always correctly code nonfacility place of service codes
on Part B claims which had resulted in overpayments. Based upon the sample
results the OIG estimated that Medicare contractors nationwide overpaid
physicians $9.5 million for incorrectly coded services provided during calendar
year 2009. Based upon these findings the OIG has recommended that CMS recover
the overpayments and Medicare contractors have also been instructed to reopen
claims associated with these type of services coupled with enhancing education
to physicians regarding the importance of correctly coding the place of service.
More information on the Region V meeting will be included in the next issue of
the Northern Ohio Physician magazine.
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