CMS recently clarified the use of modifier -KX (requirements specified in the medical policy have been met) in response to an Office of Inspector General report that identified conflicting guidance that resulted in $4.6 million in improper payments.
The OIG will be scrutinizing how CMS collects overpayments, according to a recent update to its Work Plan. The agency will be looking at whether CMS followed recommendations to improve and increase collections.
This week’s Medicare updates include the release of the 2019 Inpatient Prospective Payment System proposed rule, the publication of the feedback CMS received following a request for information on initiatives to improve the quality of healthcare while reducing cost, the announcement of the new Data-Driven Patient Care Strategy, and more!
A coding audit may be conducted by internal staff or external entities, typically representing the insurers paying for the care. When planning to implement a coding auditing program, the type of reviews, focus areas, and review frequency must all be taken into consideration.
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), it is estimated that more than half a million people in the U.S. have Crohn’s disease. For unknown reasons, the disease has become more widespread in both the U.S. and other parts of the world.
