News & Analysis

May 1, 2018
Briefings on APCs

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.

May 1, 2018
Briefings on APCs

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.

May 1, 2018
Briefings on APCs

CMS recently released MLN Matters SE18001 to provide healthcare practitioners with instructions and coding guidance for specimen validity when performed and billed in combination with drug testing. The article was issued to remind laboratories and other providers performing urine drug testing that specimen validity testing (SVT) is not separately billable.

April 25, 2018
HIM Briefings

Medicare billing edits such as National Correct Coding Initiative (NCCI) edits and Medically Unlikely Edits (MUE) must be resolved at their root cause so that they do not continue to occur on claim

April 18, 2018
Medicare Insider

This week’s Medicare updates include a list of new topics proposed for recovery audit review, a final decision memo for an NCD on MRI coverage, notice of the new interest rate for overpayments and underpayments, and more! 

April 11, 2018
Medicare Insider

This week’s Medicare updates include a final rule on various policies throughout the Medicare program involving drug pricing, the final 2019 Medicare Advantage rate announcement and call letter, a list of newly added waived test codes, and more! 

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