Health and Human Services (HHS) Office of Inspector General (OIG) Finds Medicare Paid $6.7 Billion in Improper Evaluation and Management (E/M) Services 
A report  issued by the OIG found that 21 percent of Medicare payments for E/M services in 2010 were incorrectly coded or lacked documentation, resulting in $6.7 billion of inappropriately paid claims. The report found that 42 percent of the claims were incorrectly coded. These errors included both upcoding (billing at higher levels than warranted) and downcoding (billing at lower levels than warranted). 19 percent of the claims lacked documentation.
CMS found that E/M services are 50 percent more likely to be paid for in error than other Part B services. The report recommended that CMS educate physicians on coding and documentation requirements for E/M services, continue to encourage contractors to review E/M services billed for by high-coding physicians and follow up on claims for E/M services that were paid in error.