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Q: One of the biggest challenges for case management directors is gaining the physician’s cooperation with documentation as they continue to face high patient volumes. What approaches should be taken to get physicians on the same page as case management directors?

Hacking incidents in healthcare increased dramatically as organizations dealt with the novel coronavirus (COVID-19) pandemic throughout 2020, according to a recent report from Protenus, a Baltimore-based healthcare analytics company.

Sunrise Hospital & Medical Center in Winchester, Nevada, submitted Medicare claims for rehabilitative services that did not comply with Medicare billing requirements, resulting in an estimated $23.6 million in overpayments submitted over a two-year period, according to an April Office of Inspector General (OIG) report.

Q: How does CMS calculate payments to rural health clinics (RHC) subject to the all-inclusive rate (AIR)?

Q: We have a patient admitted for COVID-19 who is now showing signs of cytokine release syndrome (CRS). Can you give our team more information on symptoms or clinical indicators for CRS as well as any ICD-10-CM coding advice?

CMS has begun recovering COVID-19 Accelerated and Advance Payments (CAAP), according to MLN Matters SE21004.

Q: We have heard that Medicare short-stay inpatient admissions may soon come under increasing audit scrutiny by Livanta, the Beneficiary and Family-Centered Care Quality Improvement Organizations that was awarded the nationwide contract for reviewing these admissions. What can we do to reduce our audit risk?

Mobile Anesthesiologists, an Illinois-based company offering healthcare services throughout the country, reported a breach in March affecting 65,403 individuals, according to the Office for Civil Rights breach report.

CMS is holding payments for claims submitted on or after April 1 in anticipation of legislation that will extend the suspension of a 2% cut (sequester) to all Medicare payments, according to a special edition of MLN Connects.

Q: What revenue codes are used to prevent triggering a copay or deductible when billing Medicare for COVID-19 monoclonal antibodies?