Don’t assume hospitalization equals GIP eligibility. GIP has long been a target for medical review by Medicare contractors, but now the scrutiny may be kicking up a notch. The HHS Office of Inspector General has listed “Audit of Selected, High-Risk [...]
Question: Do the CMS 2022 guidelines require modifier 25 for an evaluation and management (E/M) cardiology office visit code when billing EKG code 93000? Connecticut Subscriber Answer: When you bill 93000 (Electrocardiogram, routine ECG with at least 12 leads; with interpretation and [...]
Question: We saw a patient with gout and we aren’t sure how to report this condition, because the ICD-10 code book contains dozens of codes for this condition. Can you advise? Ohio Subscriber Answer: Gout is a condition that occurs [...]
Hint: The fifth character in a gout Dx code tells you the exact anatomic location. Since ICD-10-CM offers so many diagnosis codes to choose from, it can be difficult to know which ones you should report on specific claims. For [...]
If you’re curious about what others in your field are borrowing from the CARES Act Provider Relief Funds, there’s a new public resource that can help you find out. A list at https://data.cdc.gov/Adminis trative/HHS-Provider-Relief-Fund/kh8y-3es6/data details “providers that received a payment [...]
‘We know it’s not free money,’ CEO says. If you’re wondering whether you should pocket the Provider Relief Funds the feds automatically deposited in your account or return them, you’re in good company. In discussing their 2020 Quarter 1 earnings, [...]
Learn a valuable lesson from this $2.3 million HIPAA settlement. If you skimp on risk management or other HIPAA core duties, you may have to pay big when a breach occurs. That's what one health care provider has recently discovered. [...]
Human Rights Watch identifies drugs as a nursing facility mechanism of controlling residents with dementia. Human Rights Watch released a 157-page report in early February detailing visits to nursing facilities in six states in the U.S. and finding evidence of [...]
OCR continues to make examples of those that skimp on risk management. HIPAA issues arise at even at the most seasoned practices. However, a recent settlement suggests that if the feds discover compliance negligence after repeated inquiries to fix it, [...]
Access issues loom if pay reform isn't budget neutral, expert warns. The home health industry's tooth-and-nail fight to head off the disastrous Home Health Groupings Model has succeeded - at least in the short term. Late Nov. 1, the Centers [...]
