OIG is zeroing in on dermatology billing practices—modifier 25 claims and skin substitute payments are under active review.
The OIG has made it clear: dermatology billing practices are under heightened scrutiny. Two Work Plan items—modifier 25 usage and skin substitutes—signal potential compliance and audit risk for practices nationwide.
Key Risks to Know:
- Modifier 25: Improper billing of E/M services on the same day as minor surgery may trigger compliance findings.
- Skin Substitutes: Part B spending has surged past $10B annually, with fraud, waste, and abuse cited as urgent concerns.