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.
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.
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.
Providers should be preparing for another rulemaking cycle from CMS as we hit April, with the IPPS rule expected to include a discussion on how the existing payment system can address new and emerging cellular and gene therapies.
In today’s uncertain regulatory environment, establishing an internal audit process is more important than ever to ensure proper billing and reimbursement. Follow these eight steps to establish an efficient internal audit and compliance program.
