CMS hit the brakes on making imminent changes to the oft-used evaluation and management (E/M) code set that’s tied to billions of dollars in medical practice revenue.Read More »
Auditors could be able to extrapolate findings to larger pools of claims, according to a CMS proposed rule. An auditor could pull 30 claims, find a total overpayment of $1,000, which would mean an average...Read More »
Two physicians and three nurses were sentenced last week in a $11.3 million Medicare fraud scheme involving false and fraudulent claims for home health services, the OIG...Read More »
If you search for Patient Safety Indicator (PSI) 90 (Patient Safety and Adverse Events Composite) in the Agency for Healthcare Research and Quality’s (AHRQ) Version 7.0 software released in October 2017, you won’t find it.
The number of upcoded cases for patients who underwent gastrointestinal (GI) surgeries increased over a 10-year period, according to a retrospective study conducted by researchers at Johns Hopkins University...Read More »
