CMS determined the improper payment rate for immunosuppressive drugs was 15.7% in 2023, with a projected improper payment amount of $43.2 million. Organizations should review CMS' guidance on proper billing codes, coverage criteria, common denial reasons, and documentation requirements.
Patients diagnosed with a malignant neoplasm, commonly known as cancer, are now living longer due to better treatments. In 2025, there are 47 new ICD-10-CM codes to be used to report lymphoma in remission. This article broadly reviews those new codes.
A recent case centered on the misuse of evaluation and management (E/M) codes in emergency department billing offers valuable insights for HIM professionals.
