DIABETES WITHOUT CC/MCC DRG Code 639

Hospice audits get a second spotlight. If you were hoping the HHS Office of Inspector General’s focus on hospice fraud scrutiny would be in your rearview, that’s not the case quite yet. In its new semiannual report to Congress, the [...]

Report to Congress conveniently omits the fact that OIG had to walk back nearly half of its noncompliant determinations in HHA audits. For anybody who missed the HHS Office of Inspector General’s slew of hospice audit reports this year, they [...]

Thanks to a federal watchdog agency, one HHH Medicare Administrative Contractor is now collecting more hospice per-beneficiary cap-related overpayments. When it examined cap year 2017, the HHS Office of Inspector found that Palmetto GBA “accurately calculated cap amounts but did [...]

Thanks to a federal watchdog agency, one HHH Medicare Administrative Contractor is now collecting more hospice per-beneficiary cap-related overpayments. When it examined cap year 2017, the HHS Office of Inspector found that Palmetto GBA “accurately calculated cap amounts but did [...]

Proposed rule for MPFS 2021 also continues some changes due to COVID-19. August 3 brought the introduction of the Calendar Year (CY) 2021 Medicare Physician Fee Schedule (PFS) proposed rule from CMS – and there were quite a few surprises [...]

High-profile cases paint industry with fraud brush. The hospice industry continues to draw fraud-fighting attention from the feds, as shown in a recent report on the Health Care Fraud and Abuse Control Program operated jointly by the OIG and DOJ. [...]

The industry is still living down the Dr. Jacques Roy case. Don't expect fraud and abuse scrutiny to let up any time soon, with the HHS Office of Inspector General reporting $2.4 billion in judgements and settlements in fiscal year [...]

Question: Could you explain how to report ICD-10 codes for carpal tunnel syndrome (CTS)? Our coders have had a problem transitioning from ICD-9 to ICD-10 on our CTS claims. New York Subscriber Answer: ICD-10 premiered in October of 2015, but some coders [...]

Heads up: Don’t ignore categories with associated signs and symptoms. A patient who suffers from carpal tunnel syndrome (CTS) is experiencing a compression neuropathy. This compression can lead to paresthesia, pain, numbness, and other symptoms in the distribution of the [...]

Question: Since ICD-10 premiered, I’ve been having some trouble choosing the correct diagnosis codes for carpal tunnel syndrome (CTS). Can you offer any advice on choosing CTS codes using the new diagnosis system? North Carolina Subscriber Answer: You are not alone. Since [...]