OIG targets cardiac caths, biopsies for review

The Office of Inspector General (OIG) added a nationwide review of cardiac catheterizations and heart biopsies to its 2014 work plan. The work plan spells out federal priorities with a focus on reducing waste and fraud in Medicare and Medicaid programs.

The OIG announced that it would begin reviewing Medicare payments for right heart catheterizations and heart biopsies billed during the same operative session to determine if hospitals are complying with Medicare billing requirements. The initiative will launch in fiscal year 2014 and the OIG expects to issue a report in fiscal year 2015.

It wrote that previous reviews revealed hospitals had received payments for separate right heart catheterization procedures when the services were already included in payments for heart biopsies. “To be processed correctly and promptly, a bill must be completed accurately,” according to the work plan.

The work plan lists more than 100 ongoing and new reviews scheduled for fiscal year 2014. Ongoing reviews include scrutiny of Medicare payments for high-cost diagnostic radiology tests and a review of Medicare Part B payments for imaging services.