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Overland, Ordal, Thorson, and Fennell Pulmonary Consultants Agreed to Pay $79,500 for Allegedly Violating the Civil Monetary Penalties Law by Submitting Claims for Upcoded Evaluation and Management Services

Overland, Ordal, Thorson, and Fennell Pulmonary Consultants, P.C. (OOTFPC), Oregon, agreed to pay $79,792.33 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that OOTFPC submitted claims to Medicare for Evaluation and Management services (CPT codes 99204, 99214, 99205 and 99215) and Consultation services (CPT Codes 99244 and 99245) using a higher paying CPT code than supported by the medical documentation. OIG also alleged that OOTFPC submitted claims for prolonged service code (CPT 99354) when the service did not meet Medicare guidelines.

Action Details

  • Date:September 12, 2014
  • Enforcement Types:
    • CMP and Affirmative Exclusions