Carolinas Hospital in Florence, South Carolina, received $431,757 in Medicare overpayments for incorrectly billed inpatient and outpatient services, according to an Office of Inspector General (OIG) audit report released November 26. Based on the sample, the OIG estimates the hospital may have received at least $3.4 million in overpayments.
In the 2020 Medicare Physician Fee Schedule (MPFS) final rule, CMS put a stamp of approval on its previous proposals to overhaul how medical practices will report office and outpatient E/M services in 2021.
The Centers for Disease Control and Prevention (CDC) updated its clinical guidance for diagnosing and treating electronic cigarette- or vaping-associated lung injuries (EVALI) in light of the approaching 2019-2020 flu season.
Medicare made $54.4 million in improper payments to acute care hospitals for post-acute transfers that did not comply with Medicare’s policies, according to a November 1 report from the Office of Inspector General (OIG).
Q: I'm told, although I'm not convinced, that our payment for Keytruda is denied by Anthem when we use ICD-10-CM code Z51.11 (encounter for antineoplastic chemotherapy) first followed by the code for cancer, i.e., C34.12 (malignant neoplasm of upper lobe, left bronchus or lung). I reviewed the coding guidelines again and that is our instruction. Does anyone have experience with this issue?
CMS recently announced that the Medicare Fee for Service (FFS) improper payment rate is at its lowest level since fiscal year (FY) 2010. The FY 2019 improper payment rate is 7.25%, according to the U.S. Department of Health and Human Services’ (HHS) annual Agency Financial Report.
Medicare overpaid providers $640,452 for chronic care management (CCM) services and may have overpaid outpatient facilities an additional $1.2 million for CCM, according to an Office of Inspector General (OIG) report released November 7.
The fiscal year (FY) 2020 ICD-10-CM Official Guidelines for Coding and Reporting, released shortly after the FY 2020 ICD-10-CM code release, provide instructions for healthcare professionals on how to appropriately report complex diagnoses. Coders should take time to review these changes that were implemented October 1.
In today’s virtual environment, with its focus on flexible schedules, organizing the coding function requires consideration of time zones, team member skills, volume of work, and claim-processing schedules.
