The OIG has issued their Semiannual Report to Congress for the period April 1, 2021 through September 30, 2021. The report highlights nearly...
OIG to Audit High Risk DRGs
The OIG has released the November update to their Work Plan. The most recent update includes plans to audit hospital claims billed with mechanical v...
CMS Finalizes Major Changes for Split/Shared and Critical Care
The 2022 CMS Final Medicare Physician Fee Schedule (MPFS) contains substantial changes to the split/shared and critical care rules. These changes impa...
2022 OPPS Final Rule
CMS released the 2022 Final OPPS rule yesterday. The 1,394 page Final Rule contains a number of notable items including: CMS wil...
2022 Final Medicare Physician Fee Schedule
CMS has released the 2022 Final Physician Fee Schedule. The release contains many notable provisions which will become effective on January 1, 2022 as...
It is Time to Prepare for 2022 CPT
The implementation deadline for the newest version of CPT is January 1, 2022. With just over 2 months to prepare, the time to plan and take acti...
Increased Enforcement for Risk Adjustment Coding
Risk adjustment coding has the been source of several recent large, false claims act settlements and is also the topic of a recent OIG Work Plan Audit...
2022 ICD-10-CM/PCS CHANGES RAPIDLY APPROACHING
In less than one month, the 2022 edition of ICD-10-CM/PCS will become effective. This edition contains hundreds of ICD-10 code changes that incl...
PROPOSED CHANGES TO HOSPITAL PRICE TRANSPARENCY RULE
In the 2022 Proposed OPPS rule, CMS proposed increased penalties for non-compliance with the Hospital Price Transparency Final Rule. Backg...
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