A Comprehensive Error Rate Testing (CERT) study found that the improper payment rate for radiation therapy planning claims was significantly higher than many other physician specialty services, according to the Medicare Quarterly Compliance Newsletter .
The American Medical Association (AMA) is trying to get a seat at the ICD-10 table by resolving to request inclusion as one of the Cooperating Parties. Mind you, today’s resolution at the AMA annual...
CMS provided plenty of proposed refinements to quality measures in the 2016 IPPS proposed rule, but did not suggest any changes to the 2-midnight rule. Kimberly A.H. Baker, JD, CPC, James S. Kennedy, MD, CCS, CDIP, and Shannon Newell, RHIA, CCS, highlight the most significant proposed changes.
CMS declared its second week of ICD-10 end-to-end testing , held from April 27 through May 1, a success. Approximately 875 participants submitted 23,138 test claims during the week and CMS accepted...
A Comprehensive Error Rate Testing (CERT) contractor special study found improper payments on Medicare Part B claims including HCPCS code 84999 (unlisted chemistry procedure) submitted from October to December 2013, according to the latest Medicare Quarterly Compliance Newsletter .
Providers have one last chance to volunteer for ICD-10 end-to-end testing, with CMS extending the deadline to sign up for the July testing period through May 22.
An automated Recovery Auditor review of discharge status codes identified improper payments, according to the Medicare Quarterly Compliance Newsletter . However, CMS did not report the prevalence of the errors.
CMS released updated I/OCE specifications in January with several changes that could require providers to examine claims submitted early in 2015 that include comprehensive APCs (C-APC) to ensure proper payment.
A Recovery Auditor automated review of claims for cardiovascular nuclear medicine procedures found potential incorrect billing due to lack of medical necessity, according to the latest Medicare Quarterly Compliance Newsletter.
Dave Fee, MBA, identifies updates to CMS' programming logic for comprehensive APCs and provides a step-by-step approach to determine whether a complexity adjustment will be applied.
A Comprehensive Error Rate Testing (CERT) study of transcatheter aortic valve replacement/implantation (TAVR/TAVI) services found that approximately one third of the claims received improper payments, mostly due to insufficient documentation, according to the latest Medicare Quarterly Compliance Newsletter.
The 2014 ICD-10 implementation delay negatively impacted ICD-10 preparations, according to the Workgroup for Electronic Data Interchange (WEDI) February 2015 readiness survey .
CMS Transmittal 3217 , effective April 1, will allow inpatient-only procedures to be included on inpatient claims, similar to other outpatient services included in the three-day window.
Providers who want to volunteer to participate in CMS' final round of ICD-10 end-to-end testing have until April 17 to sign up through their Medicare Administrative Contractor's (MAC) website.
Three university hospitals saw a doubling of Recovery Auditor audit activity from 2010–2011 to 2012–2013, and a nearly three-fold increase in overpayment determinations, according to a new study in the Journal of Hospital Medicine.
Just when we were starting to feel really good about ICD-10’s chances of being implemented, AHIMA has learned that Chairman of the House Rules Committee Pete Sessions, R-Texas, is looking to draft...
