Anne Arundel Medical Center in Annapolis, Maryland, will pay $3,154,000 to settle allegations that it submitted false claims to Medicare for medically unnecessary evaluation and management services and separately billing bundled procedures
ED physicians commonly treat fractures. A fracture can be the result of a traumatic injury, such as a fall, or may be pathologic (i.e., due to a disease process). In general, fractures can be classified as open or closed, displaced or nondisplaced.
In 2013, “Guidelines for Achieving a Compliant Query Practice,” a collaboration between AHIMA and ACDIS, was published. It has served as the industry guideline for the establishment of best practices surrounding queries. The 2019 update reinforces the information set forth in the preceding practice briefs while also introducing some newer guidelines reflective of today’s healthcare environment.
Before starting an ambulatory or outpatient CDI program, those tasked with the project must first create some universal definitions so everyone is on the same page and speaking the same language.
CMS recently released two quarterly updates effective July 1: Medicare Claims Processing Transmittal 4313, which is the July update to the OPPS, and Medicare Claims Processing Transmittal 4314, which is the related July update to the Integrated Outpatient Code Editor (I/OCE) Specifications, Attachment B.
