The federal healthcare program Anti-Kickback Statute is a broad criminal statute. Recognizing the breadth of this statute, Congress and the OIG have established numerous statutory and regulatory safe harbors. Brush up on safe harbors and tips for compliance.
Robotic and computer-assisted surgical procedures are still considered new technology in many hospitals despite having been used in the U.S. for many years. Review coding guidelines and code selection rules for these procedures.
Release of information (ROI) services require specific devices, tools, and other supplies to process and produce records as requested. Ensure your ROI staff have what they need to keep up with all requests.
Uncommon MS-DRGs can be a red flag to auditors even when the encounter is correctly assigned to one. Use these tips to ensure coding and documentation supports the use of these MS-DRGs.
Clinical validity denials occur when there is a lack of clinical evidence in the patient chart to support a billed diagnosis. Learn more about common reasons for these denials and how to defend against them.
The 2023 Medicare Physician Fee Schedule ushered in a slew of changes to payment rates, coding guidelines, and telehealth coverage. Review key changes to ensure your organization is in compliance.
With reimbursement gains whittled down by CMS' attempt to remedy unlawful cuts to 340B drug payments, complying with updated Outpatient Prospective Payment System (OPPS) policies is key to protecting reimbursement. Take a closer look at CMS' latest policies and ensure your organization is in compliance.
