In the first half of the 2014 fiscal year, the Office of the Inspector General (OIG) reported more than $3 billion in audit recoveries, nearly $3 billion recovered from investigations, and nearly a million in other non-Department of Health and Human Services (HHS) investigations due to efforts...Read More »
Physician evaluation and management (E/M) payments cost Medicare $32.3 billion in 2010—about 30% of all Part B payments that year—and of that amount, about $6.7 billion were incorrectly coded or documented, according to an Office of...Read More »
The Office of the Inspector General (OIG) found that Robert Packer Hospital in Sayre, Pa., part of Guthrie Health System, was overpaid $1.876 million, according to a new Medicare compliance review. An audit of nearly 300 claims submitted beween 2009 and...Read More »
The new ICD-10-CM/PCS implementation date looks to be October 1, 2015. CMS mentioned October 1, 2015, as the new date three times in the IPPS Proposed Rule, released April 30. The following day, CMS released a statement verifying its plan for an October 1, 2015, implementation.Read More »
Oakwood Hospital and Medical Center (the Hospital), in Dearborn, Mich., is the latest facility to fall under the sights of the Office of the Inspector General (OIG) for inappropriately assigning diagnosis code 260 for Kwashiorkor.Read More »
Q: I am a relatively new CDI specialist in a relatively new CDI program. We learned that we should be examining the health record with an eye toward “what bought the bed.” When we raise this concept to our coders, however, they disagreed with the premise telling us that such a concept was...Read More »
