Office of Inspector General (OIG) Comment on Facet Joint Injections

The Office of Inspector General (OIG) released the "2010 Compendium of Unimplemented OIG Recommendations". The OIG summary of the status of the recommendations regarding facet joint injections states that, "because of the lack of medical consensus on the frequency issue, OIG is concerned that the MAC (Medicare Administrative Contractors previously known as Carriers) will default to the least restrictive requirement, which in some cases could be no limit."

In its original report the OIG recommendations were that Medicare should (1) strengthen program safeguards to prevent improper payment for facet joint injection services; (2) clarify billing instructions for bilateral services; and (3) act to resolve the miscoded, undocumented, medically unnecessary services.

ISIS has been working hard with payers and reimbursement bodies to improve their understanding of the value of these services when performed in appropriate manner and to address concerns raised in the OIG report.