What do audits performed by the OIG primarily review?

Audits performed by the Office of Inspector General (OIG) primarily focus on assessing compliance with federal regulations concerning healthcare operations. This includes reviewing both coding practices and documentation requirements.

Coding practices are critical because they determine how services are billed to Medicare and other payers; accurate coding is essential for compliance with legal and reimbursement standards. If coding is inaccurate, it might lead to financial losses, overpayments, or even allegations of fraud.

Documentation requirements are equally important, as they provide the necessary support for the billed services. Proper documentation must demonstrate that the care provided meets both clinical standards and payer policies. Insufficient or poor documentation can result in denials of claims or legal concerns regarding the quality of care.

The inclusion of accounting practices in the OIG's audits, while significant for financial oversight, does not align as directly with the primary focus areas of coding and documentation in healthcare compliance audits. Therefore, the combination of coding practices and documentation requirements encapsulates the core objectives of OIG audits, making the choice that encompasses both of these areas the most accurate representation of their focus.