Government
OIG finds overpayment for surgical debridement
NEWS IN BRIEF — Posted July 9, 2007
In 2004, Medicare paid more than $60 million for surgical debridement services that failed to meet program requirements for reimbursement, says the Dept. of Health and Human Services Office of Inspector General.
Sixty-four percent of the debridement services claimed in that year did not meet at least one of the program's reimbursement requirements, including proper coding and medical documentation, the OIG reported. Medicare carriers in many cases did not conduct medical reviews that would have uncovered the improper claims.
The OIG recommended that the Centers for Medicare & Medicaid Services order carriers to conduct more of these reviews. It also suggested that CMS implement a national coverage determination for surgical debridement services that would standardize the reimbursement requirements. The agency said it had no plans to do so.
Note: This item originally appeared at http://www.ama-assn.org/amednews/2007/07/09/gvbf0709.htm.
