CMS determined the improper payment rate for immunosuppressive drugs was 15.7% in 2023, with a projected improper payment amount of $43.2 million. Organizations should review CMS' guidance on proper billing codes, coverage criteria, common denial reasons, and documentation requirements.
Ransomware threats in healthcare are growing. For instance, just look at three settlements from the Office for Civil Rights (OCR) occurring this past October. These enforcements mark the OCR's fifth, sixth, and seventh actions related to ransomware, and underscore the vital importance of proper cybersecurity safeguards.
The Office of Inspector General (OIG) released its Semiannual Report to Congress, which details its recent oversight efforts related to opioid use disorder.
Make sure staff who handle audit requests understand when a missing signature should — or should not — trigger an automatic denial of your claims or prior authorization requests. Recent guidance from CMS clarifies how auditors should proceed when a medical record lacks a signature.
Hamilton Lempert, MD, FACEP, CEDC, reviews the basics of CPT critical care services and addresses common reporting questions, such as services that pass midnight, continuous care, and which clinical tasks count toward critical care.
Cybersecurity has dominated headlines recently with a series of significant breaches highlighting the vulnerabilities within the U.S. healthcare sector.
This article reviews malware basics and covers tips that healthcare employees can implement to avoid cyberattacks that could put protected health information (PHI) at risk.
The National Institute of Standards and Technology's (NIST) updated publication provides practical guidance and resources that can be used to help safeguard health information and better understand the security concepts discussed in the HIPAA Security Rule.
