This week’s Medicare updates include recent fraudulent billing activity among certain DMEPOS suppliers, a final decision memo on coverage of transcatheter aortic valve replacements, and more!
The prevalence of healthcare-associated infections (HAI) in U.S. hospitals declined between 2015 and 2023, according to a CDC survey recently published in The New England Journal of Medicine.
Thyroid disorders challenge outpatient hospital coders because the record often contains symptoms, laboratory values, medications, imaging findings, and surgical history before it contains a clear final diagnosis. Those clues can help a coder understand the encounter, but they do not authorize the coder to diagnose the patient.
This week’s Medicare updates include recent fraudulent billing activity among certain DMEPOS suppliers, a final decision memo on coverage of transcatheter aortic valve replacements, and more!
UnitedHealthcare is fulfilling its pledge to reduce prior authorization requirements by 30% by the end of the year. Starting October 1, 2026, the insurer will no longer require approval for more than 1,700 procedure codes across various plans.
Payer requirements are constantly changing, while the information that organizations need to respond to those changes can be scattered and difficult to pull together.
CMS released an advisory for certain clinicians who are qualifying alternative payment model (APM) participants, notifying them that their current billing information must be updated to receive funds for the 2026 payment year.
