CMS may have overpaid hospitals, physicians, and freestanding facilities almost $270 million for polysomnography services that did not meet Medicare requirements over a two-year period, according to an Office of Inspector General report.
Q: Our clinical trial claims often hit edits for missing drugs or devices when those are supplied by the trial sponsor and we can't bill for them. We've been manually reviewing these edits. Is there a recommended method for handling these types of edits that's more efficient?
It can be impractical for medical researchers to seek authorization from all the patients whose medical records are sought for a study. That’s why HIPAA allows researchers to use de-identified PHI from records without individual authorization.
Q: We have a patient who received a pancreas transplant for the treatment of diabetes. The patient was later admitted to the hospital for treatment of an unrelated kidney stone. Would I still need to assign the ICD-10-CM code for diabetes as a chronic condition based on the patient’s medical history?
