Yesterday, CMS released the Medicare Advantage (MA) Risk Adjustment Data Validation Final Rule. The Final Rule is intended to strengthen the acc...
CMS Releases the 2023 IPPS Proposed
CMS released the 2023 Proposed Inpatient Prospective Payment Rule. The 1,786 page document includes some major changes for the upcoming year inc...
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...
2022 ICD-10 Coding Update
The 2022 edition of ICD-10 contains over 200 diagnosis coding changes. The CDC has just announced its release of the FY 2022 ICD-10-CM code set ...
OIG Recommends Targeted Audits of MS-DRGs
Last week, the OIG released a report on Part A claims for inpatient hospital stays from FY 2014 through FY 2019. The report indicates that approximate...
2021 ICD-10 Effective October 1
The 2021 edition of ICD-10 contains over 500 diagnosis coding changes. The updates will become effective in just 9 days, on October 1st, 2020.&n...
OIG Workplan Update- COVID-19 Audits
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 ...