OIG Reports on Incorrect Place of Service Coding Overpayments.

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently reported that Medicare potentially overpaid physicians due to incorrectly submitted place of service (POS) codes from January 2010 through September 2012.  Medicare reimburses physicians at a higher rate for services performed in non-facility locations.  The OIG report found that physicians incorrectly submitted claims as performed in non-facility locations when the services were actually provided in facility locations.  The physician POS coding errors amounted to approximately $33.4 million in potential Medicare contractor overpayments.

The OIG recommended that the Centers for Medicare & Medicaid Services (CMS): (1) commence immediate recovery efforts of overpayments; (2) monitor recovery by physicians who agreed to refund overpayments; (3) educate physicians and billing personnel on the importance of internal controls to ensure correct POS coding; and (4) strengthen efforts to identify physician services at high risk for POS miscoding.  CMS concurred with the OIG recommendations.

The OIG report is available at:

http://oig.hhs.gov/oas/reports/region1/11300506.pdf.

The Department of Health and Human Services Office of Inspector General.  “Incorrect Place-of-Service Claims Resulted in Potential Medicare Overpayments Costing Millions.”  A-01-13-00506.  8 May 2015.