News & Analysis

April 10, 2019
Medicare Insider

This week’s Medicare updates include the Medicare Advantage and Part D rate announcement and final call letter, a fact sheet on the Preclusion List, updates to provider self-disclosure settlements, and more! 

April 8, 2019
Medicare Web

Q: How do Medically Unlikely Edits (MUE) apply to clinical trials claims?

April 3, 2019
Medicare Web

The Government Accountability Office (GAO) recommended that CMS assess and strengthen documentation requirements and medical reviews to more effectively prevent improper payments.

April 3, 2019
Medicare Insider

This week’s Medicare updates include a proposed decision memo for transcatheter aortic valve replacements, clarification on a transmittal regarding evaluation and management coding, an article on edits for OPPS providers with multiple service locations, and more!

April 1, 2019
Briefings on APCs

Hospital coders must develop and adhere to internal E/M coding guidelines and CPT guidance to accurately report visits to the ED. In addition, because ED coding encompasses professional and facility billing, they may need to scour provider documentation to determine the correct E/M service level for both bill types.

April 1, 2019
Briefings on APCs

Telehealth services are likely to promote health, wellness, and disease management, providing an avenue to offer efficient, high-quality care while supporting value-based care in a cost-effective manner. Although the benefit of telehealth is obvious and its value is continually highlighted by CMS, it appears the services are underutilized.

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