The OIG analyzed E/M services using the Part B Analytics Reporting System to determine coding trends from 2001 to 2010. The report found some physicians consistently billed higher-level E/M claims (i.e., used more complex and more expensive E/M codes), which was a factor to the increase Part B payments during that same time period.
From 2001 to 2010, the OIG found physicians increased their billing of higher-level E/M codes in all types of E/M services, and of those physicians, roughly 1,700 consistently billed higher-level E/M codes in 2010, although it was not determined if all E/M claims from these physicians were inappropriate.
OIG listed three recommendations, which CMS agreed with: continue to educate physicians on proper billing for E/M services, encourage contractors to review physicians’ billing for E/M services and review physicians who bill higher-level E/M codes for appropriate action.
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