News & Articles

Featured Article

Coding

Official Date for ICD-10 Implementation Announced

The U.S. Department of Health and Human Services (HHS) issued a rule Aug. 4 finalizing Oct. 1, 2015 as the new compliance date for healthcare providers, health plans, and healthcare clearinghouses to transition to ICD-10, the tenth revision of the Interna... Read More >>

July 31st, 2014

CMS Introduces Four New Modifiers in Lieu of Modifier 59 Differentiate Per Vaccine/Per Component Coding for Immunizations

Auditing

Take a Medicaid Moment: Use Proper Consent Forms

Know federal and state Medicaid policies for entitlement and their use. You shouldn’t expect your state Medicaid fund to pay or behave the same as other third-party payers, or even Medicare. Medicaid is a federal entitlement program incepted through... Read More >>

January 1st, 2014

OIG Continues to Focus on POS Errors, and So Should You KHN: Retooling Hospitals, One Data Point At A Time

Practice Management

Weigh in on Proposed MPFS

If you want to weigh in on the next few years' physician fee schedule, do it before September 2. On July 3, the Centers for Medicare & Medicaid Services (CMS) placed the 2015 Physician Fee Schedule proposed rule on display in the Federal Register ... Read More >>

August 18th, 2014

CMS Proposes Coverage of Colorectal Cancer DNA Test Physician Compare Website Aggregates More Data Under Proposed Rule

Compliance

Warning: Import Text Properly

[On the Cover] Ensure clinical documentation integrity in your electronic health records. By Michael Stearns, MD, CPC, CFPC There are advantages and disadvantages associated with the use of imported text in electronic healthcare records (EHRs). Let... Read More >>

June 1st, 2014

Laparoscopic-to-open Surgery Coding Understanding the Multiple Procedure Rule

Billing

Best Practice for Speeding Up Claims Payment

You can improve the turnaround time it takes to get claims paid by avoiding this common billing taboo: Don't report the same procedure code on multiple lines to account for units of service. There's a more efficient billing method that will help your... Read More >>

August 6th, 2014

OPPS/ASC October Update Draws Attention CMS Open Payment Is Running Again, Deadline Extended

News

You Have the Power to Prevent Fraud, Waste, and Abuse

The Office of Inspector General (OIG) makes it as easy as the click of a button to report fraud, waste, abuse, and mismanagement in the U.S. Department of Health & Human Services' programs. Through the OIG Hotline Operations’ “Report Fraud” link... Read More >>

August 21st, 2014

Payer Appeals: Always Verify Delivery, and Be Wary of “Internal” Appeals Surgery Arthroscopy Includes Debridement (with an Important Exception)