MASTECTOMY FOR MALIGNANCY WITH CC/MCC DRG Code 582

Prescription fraud, E/M upcoding, and more factor in latest settlements. You might have noticed that the feds seem to be ramping up their midyear fraud enforcement activity. In fact, June was a particularly busy month with more than 35 civil [...]

Prescription fraud, E/M upcoding, and more factor in latest settlements. You might have noticed that the feds seem to be ramping up their midyear fraud enforcement activity. In fact, June was a particularly busy month with more than 35 civil [...]

Medicare, Medicaid made up 71 percent of home health spending in 2019, according to CMS. While many home health agencies may have struggled financially in 2019, the newly released spending figures on the service show a healthy picture. Spending for [...]

Tip: Concise documentation will be critical in 2021. Medicare hasn’t released all the annual improper payment rate details yet — but it’s clear documentation woes continue to plague providers. The Centers for Medicare & Medicaid Services (CMS) recently announced the [...]

Hint: Inadequate documentation remains a problem. If you’ve been waiting patiently for Medicare’s improper payment rate estimates, you’re in luck. Even though the data points to rate declines from federal corrective actions, improper payments are estimated in the billions. Context: [...]

Insufficient documentation continues to plague HH claims. Not all the details are out about Medicare’s latest annual improper payment rate findings, but it’s clear that home health agencies continue to make fewer claims errors. The Centers for Medicare & Medicaid [...]

Make HIPAA security a priority to secure patient data. You’ve put passwords on your computer files, locked your paper records behind closed doors, and asked patients to sign off on your privacy practices, so your protected health information (PHI) is [...]

Put protocols in place that make HIPAA security a priority. Accidental disclosures, privacy muddles, and IT attacks are major players in the fight to secure protected health information (PHI) nowadays. Most arise from carelessness and can easily be amended with [...]

Break-ins happen more than you think. The majority of HIPAA breaches are due in part to accidental privacy snafus or IT-related hacks. Most arise from carelessness and can easily be amended with stricter office regulations. The combination of securing the [...]

Medicare creates A9525 instead, then cancels it If you're confused about which low osmolar contrast material (LOCM) codes to use, you're not the only one. But your 2005 HCPCS book brings relief. As of Jan. 1, most carriers should be [...]