News

Q: How do you know when Category III CPT code 0505T is the appropriate code to assign for a femoral popliteal revascularization?

The Revenue Integrity Symposium is a conference that truly speaks to the contemporary and emerging issues that revenue integrity professionals grapple with.

Q: How are nonclinical resources being used by Medicare to improve health outcomes and access to care under Medicare Advantage?

The Office of Inspector General (OIG) will review Medicare’s diagnosis-related group (DRG) window policy to determine whether the program could save money by expanding the policy to include more days, according to an update to the OIG Work Plan.

Q: How do we bill for items provided to a patient participating in a clinical trial that are not listed on the billing intention?

CMS could have saved its beneficiaries an additional $2.9 million in 2017 had it implemented a more expansive price substitution policy for Part B drugs, according to an Office of Inspector General (OIG) report. 

Q: What would be reported as the principal diagnosis if a patient was admitted with both a urinary tract infection (UTI) and sepsis? What would be reported first if the patient developed a catheter-associated UTI with sepsis?

Findings from a Comprehensive Error Rate Testing (CERT) study show that insufficient documentation caused most improper payments for chiropractic services billed to Medicare in 2018, according to the July 2019 Medicare Quarterly Compliance Newsletter.

Q: How can we ensure key staff are kept up to date on commercial payer changes?

The New York City Fire Department (FDNY), which operates ambulances, disclosed in August that 10,253 patients treated or transported by the FDNY from 2011 to 2018 may have had their protected health information (PHI) compromised after an external hard drive containing unencrypted data went missing in March, according to an FDNY press release.