ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC DRG Code 284

The American Podiatric Medical Association (APMA) recently brought to our attention two clarifications relating to the article “Strengthen Your Understanding of the 2024 Physician Fee Schedule,” published in Podiatry Coding and Billing Alert Vol. 16, No. 1. G2211: The Podiatry [...]

Hint: ‘Suspicious’ time can be a red flag. Ensuring your clinicians are paid for their work is a top priority, but how do you make sure that neither you nor your providers fall into the “impossible time” trap? Knowing how [...]

See where the pandemic has jumpstarted enforcement. The pandemic may have stalled business as usual at every level this time last year, but federal agencies and authorities are making up for lost time in investigating healthcare fraud and abuse. The [...]

See what the audit hot spots are. If you’ve been following the HHS Office of Inspector General’s (OIG’s) updates, then you know the feds are focusing a lot of energy on pandemic-related problems. But a closer look at audit and [...]

Number of HHA subjects investigated skyrocketed 125 percent in five years.Federal investigators are using statistics like these from a new Government Accountability Office report when deciding where to focus their scrutiny:Of the criminal cases pursued by 10 Medicaid Fraud Control [...]

Number of HHA subjects investigated skyrocketed 125 percent in five years.Federal investigators are using statistics like these from a new Government Accountability Office report when deciding where to focus their scrutiny:Of the criminal cases pursued by 10 Medicaid Fraud Control [...]

Watch out for these old codes. If you're receiving denied claims due to diagnosis coding errors, it may be time to review the list of codes that became invalid this year. Getting invalid codes off your claims will help speed [...]

Question: I read an article that said ICD-10 guidelines for anemia/neoplasm coding differ from ICD-9. Where can I access the ICD-10 guidelines? Iowa Subscriber Answer: You can download the 2010 ICD-10 guidelines from CMS's ICD-10 site: www.cms.gov/ICD10/12_2010_ICD_10_CM.asp. You also can [...]

High therapy, multiple recerts top RAC's hit list. After a lengthy delay, Medicare's bounty hunters have set their sights on home health agency services. Region C Recovery Audit Contractor Con-nolly Healthcare has posted one Centers for Medi-care & Medicaid Services-approved [...]

Question: We have been providing Methotrexate injections for our patient's rheumatoid arthritis. She began experiencing fatigue and weakness. At a doctor's appointment, she was diagnosed with pancytopenia secondary to drugs. The physician ordered blood monitoring with complete blood counts and [...]