In their most recent Work Plan update, the OIG has announced they will be auditing Medicare payments for inpatient discharges billed by hospitals for ...
CMS To Require Proof of Positive COVID-19 Test To Get 20% MS-DRG Bonus
In an Aug. 17 MLN Matters article, CMS stated that starting September 1, hospitals will lose the 20% Medicare bonus for treating inpatients ...
CMS has Delayed Implementation of Appropriate Use Criteria
Last week, CMS announced the Appropriate Use Criteria (AUC) testing period would be extended through calendar year 2021. CMS stated that there will be...
Sweeping E/M Changes Effective January 1, 2021
The AMA and CMS have released significant changes to outpatient office E/M coding. The new coding guidelines will be implemented January 1, 2021...
CMS has Released the 2021 Proposed OPPS Rule
CMS released the 2021 Proposed OPPS rule yesterday. The Proposed Rule contains a number of notable items including: Increase in hospital o...
The 2021 Medicare Proposed Physician Fee Schedule was Released Today
CMS released the 2021 Proposed Physician Fee Schedule today. The 1,353 page document contains numerous, important proposals including: Expansion ...
The OIG Plans to Audit Hospital Bad Debt
The OIG updated their Work Plan this week. Through the update, they announced they will be conducting audits of hospital bad debt. Specifi...
CMS Announces Medical Reviews Starting August 3, 2020
CMS announced through an FAQ that it will resume its Fee-For-Service (FFS) medical reviews that were previously suspended due to the COVID crisis...
Incorrect ICD-10 Assignment of Severe Malnutrition Leads to Massive Hospital Overpayments
Last week, the OIG issued a new audit report that estimates $1 Billion in Medicare overpayments to hospitals due to improper ICD-10 assignment for sev...
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