The greatest pro seems to be that if an audit begins within the office, there, perhaps, is a tendency to get the investigation out of the office sooner. The greatest risk to a physician's office seems to be to the qui tam action, which is basically a whistle-blower provision. The Congress has increased the Office of Inspector General's investigation budget by 29 percent Coding, billing, and code bundling are the high-risk areas. HCFA has added coverage for patients in clinical trials. All beneficiaries will continue to be responsible for deductibles and coinsurance.
New codes are available with more on the way.
Code 76975 cannot be coded simultaneously with an EUS code. Meanwhile, new codes are on the way for large-volume paracentesis, submucosal injection, and balloon dilation of small bowel and colon. Currently, the 1997 and 1995 guidelines are used most. The guidelines for services performed by PAs and nurse practitioners are being updated. The physician's billing number should be used only when the service is provided by the physician.