The latest Program for Evaluating Payment Patterns Electronic Report (PEPPER) was released May 24. CDI specialists may access the report via their facility QualityNet account, located here: www.qualitynet.org.
US Senator Tom Coburn, MD, (R-OK) suggests Congress hold committee hearings regarding ICD-10 implementation to evaluate its cost/benefit analysis in a position paper titled...Read More »
The Office of the Inspector General (OIG) pointed to deficiencies in CMS’ oversight of Zone Program Integrity Contractors (ZPICs), indicated that Comprehensive Error Rate Testing (CERT) program calculations could be more accurate, and pointed to unaddressed contractor-identified vulnerabilities...Read More »
The Medicaid RAC program kicked off January 1. Although the program got off to a slow start, activity will likely ramp up in the next few months. So if your hospital hasn't experienced a Medicaid audit yet, it probably will soon. As audits get under way, specific target areas will begin to...Read More »
After HHS proposed a year-long delay of ICD-10-CM/PCS, questions emerged regarding the current ICD-9-CM code freeze. CMS confirmed that the code freeze will hold until ICD-10-CM/PCS is implemented regardless of the delay, according to Pat Brooks, RHIA, senior technical advisor at...Read More »
“This claim was denied after review and it was determined that the documentation did not support the need for an inpatient level of care.”
NHIC Inc., the Medicare Administrative Contractor (MAC) for jurisdiction 14 (which includes Maine, Massachusetts, New Hampshire, Rhode Island...Read More »
