Regular monitoring and internal auditing are critical to ensure compliance throughout the revenue cycle and protect revenue integrity. Consider the different strategies that can be applied to documentation and chart audits, coding audits, and more.
Medical decision-making is one of the key components of E/M code selection. Review the guidelines to ensure correct coding and to improve internal audits.
North Mississippi Medical Center (North Mississippi) submitted Medicare claims for polysomnography services that did not comply with Medicare billing requirements, resulting in an estimated $67,038 in overpayments for polysomnography services submitted over a two-year period, according to a recent Office of Inspector General (OIG) report.
Physician and non-physician practitioners may benefit from reviewing documentation requirements and HCPCS Level II codes for knee orthoses, according to a recent Medicare Quarterly Compliance Newsletter.
Q: A patient was admitted to our facility with COVID-19-like symptoms, tested negative for COVID-19. Several days later, however, the patient was retested and found to be positive for COVID-19. Should we query the physician or assign a present on admission (POA) indicator of "no" or "unknown"?
Though the adoption of outpatient CDI has been growing steadily over the years, it’s not always easy to prove the return on investment for such efforts.
The American Medical Association’s (AMA) CPT Editorial Panel at its February meeting approved technical corrections to the E/M coding guidelines for outpatient visits. The corrections were uploaded to AMA website on March 9 and go into effect retroactively from January 1.
Identifying and appropriately coding present on admission (POA) indicators in COVID-19 patients continues to challenge coders. Use these scenarios to check your knowledge and learn how to improve.
Arthroscopic surgical procedures involve the insertion of a small scope into the interior of a joint, allowing the physician to view the joint without making a large incision through the skin. Review CPT coding for arthroscopic procedures of the hip and knee joints.
Findings from an Office of Inspector General (OIG) audit show that Blue Cross Blue Shield (BCBS) of Michigan submitted claims with high-risk diagnosis codes that did not comply with federal requirements, resulting in at least $14.5 million in overpayments to Medicare Advantage (MA).
