Q: We are trying to educate our coding department about medical necessity, but has CMS or Medicare defined it anywhere? How can we explain it to staff?Read More »
The OIG greenlit a pilot program to share patient discharge data with pharmacists in an effort to improve care planning and decrease readmissions.Read More »
No, we don’t mean the common table spice. The Program for Evaluating Payment Patterns Electronic Report (PEPPER) summarizes facility-specific data statistics for Medicare services that may be at risk for improper payments.Read More »
Upon reviewing 2,145 inpatient claims at 25 providers, the Office of Inspector General (OIG) found that all but one claim incorrectly included the diagnosis code for kwashiorkor. This resulted in overpayments in excess of $6 million, according to...Read More »
Mandatory bundled payment programs for surgical hip and femur fracture treatment along with the cardiac rehabilitation incentive payment model, were canceled by CMS last Thursday, AHA News Now...Read More »
Tammy Combs, RN, MSN, CDIP, CCS, CCDS, will present “How to Mitigate and Manage Denials,” on Day 2 of the ACDIS conference. Combs is the director of HIM practice excellence, CDI/nurse planner at AHIMA in Chicago, Illinois....Read More »
