October 5, 2020
News & Insights

A September audit by the Office of Inspector General (OIG) said Alta Bates Summit Medical Center in Oakland, California, incorrectly billed Medicare for inpatient and outpatient services between 2017 and 2019, resulting in overpayments of $1.5 million.

October 5, 2020
News & Insights

Q: How will CMS make payments for radiation therapy (RT) services under the Radiation Oncology Model rule?

September 30, 2020
News & Insights

Organizations that received Provider Relief Fund payments of more than $10,000 will be required to report information on how PRF payments were used as well as  expenses related to the novel coronavirus that were not reimbursed (COVID-19), according to new HHS guidance.

September 28, 2020
News & Insights

During a meeting in early September, members of the ICD-10 Coordination and Maintenance Committee proposed creating new ICD-10-CM codes related to screening, exposure, and personal history for the novel coronavirus (COVID-19). The new codes, if finalized, would take effect in January 2021.

September 28, 2020
News & Insights

Q: What changes to inpatient dialysis MS-DRGs did CMS finalize in the 2021 Inpatient Prospective Payment System final rule?

September 23, 2020
News & Insights

UnitedHealthcare’s (UHC) plan to require in-network, freestanding and outpatient laboratory claims to contain a unique code for most lab testing services is poorly timed and poses significant implementation hurdles, the American Hospital Association (AHA) said.

September 21, 2020
News & Insights

The use of chronic care management (CCM) CPT codes increased over a four-year period, but physicians infrequently reported codes for complex CCM, according to findings from a review of Medicare claims recently published in the Annals of Family Medicine.

September 21, 2020
News & Insights

Q: What tasks and policies should be covered in a charge capture audit process?

September 16, 2020
News & Insights

CMS provided clarification on submitting inpatient claims for patients diagnosed with novel coronavirus (COVID-19) without a positive viral test, in an update to MLN Matters SE20015 released September 11.

September 16, 2020
HIM Briefings

CMS laid the groundwork for a dramatic revision of MS-DRG rate setting in the 2021 Inpatient Prospective Payment System (IPPS). The agency also rolled out code changes and MS-DRG updates. Ensure your organization is compliance with new requirements.

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