Billing and reimbursement

The Office of Inspector General (OIG) is planning to audit hospital inpatient claims for compliance with the 2-midnight rule, according to a recent update to its Work Plan.

Review 2021 ICD-10-CM codes for behavioral health diagnoses and a breakdown of CPT guidelines for psychiatric diagnostic evaluations.

The American Medical Association (AMA) on November 10 announced a handful of new CPT codes for reporting COVID-19 vaccine products and immunization administration.

The two new FAQs address billing for monoclonal antibody treatments provided in the hospital outpatient setting.

Debbie Jones, CPC, CCA, details ICD-10-CM coding for strabismus and CPT coding for surgical treatments used to correct eye misalignment.

A formal CDI program can address many of the challenges home health agencies face, but knowing how to start one isn’t easy. Consider these tips to create a focused home health CDI program.

CMS’ guidance on the use of modifier -CS may create as many questions as it answers. Learn how to navigate lingering questions and avoid pitfalls.

Q: For the purposes of determining a Medicare overpayment, should claims that we are uncertain whether they were appropriate be included? Is this defined under the False Claims Act (FCA)?

CMS’ Fourth COVID-19 Interim Final Rule with Comment Period includes additional payment for new COVID-19 treatments, price transparency requirements for COVID-19 diagnostic tests, and coverage for potential vaccines among other provisions.

Valerie A. Rinkle, MPA, CHRI, writes about Medicare guidance on and updated payment policies for COVID-19 testing, vaccines, and telehealth services.