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.
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
This week’s Medicare updates include the April edition of the Medicare Quarterly Provider Compliance Newsletter, a new OIG compliance website providing resources for the public to use to ensure compliance, an updated OIG work plan, and more!
A CMS fact sheet reminds providers to brush up on their MIPS knowledge in regard to the quality performance category. This performance category is worth 50% of providers’ final MIPS score for 2018, and providers who demonstrate improvement from their performance in the category in 2017 could earn bonus points this year.
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!
