Findings from a CERT study show that insufficient documentation caused most improper payments for chiropractic services billed to Medicare in 2018, according to the ...Read More »
Q: I’ve heard that the GMLOS is always rounded to the nearest whole number as inpatient claims are paid by day. Based on my understanding of the IPPS, I thought that each inpatient stay is paid by a fixed amount, regardless of the...Read More »
Providence Health & Services wasn’t the only one under fire from Integra Med Analytics. The firm also filed a suit alleging that Baylor Scott & White, a large Texas-based health system, wrongly billed Medicare for more than $61.8 million over seven years through the practice of upcoding...Read More »
Q:I just had a case at work where the patient arrived in respiratory distress, was intubated, and was placed on a vent, treated with IV Solumedrol, HHN, IV antibiotics. The patient came upstairs on the vent. The physician...Read More »
After months of consternation from the CDI community over CC/MCC downgrades included in the fiscal year (FY) 2020 inpatient prospective payment system (IPPS) proposed rule...Read More »
Misdiagnoses in treatments for “big three” conditions—cardiovascular events, cancers, and infections—comprise 74% of all serious harms from diagnostic errors, according to a new study published in...Read More »
