Proposed Rule Aims to Modify Constraints under HIPAA and the HITECH Act

Click here to read the white paper.

G2211 delayed until 2024

The Consolidated Appropriations Act, 2021 has modified the Medicare Physician Fee Schedule (MPFS).  Two major [...]

Radiology Audits: A New Pilot Program from CMS

This is the all too familiar scenario.  An order for radiology services is received, the [...]

The Audit Gates Have Opened Wider

The Centers for Medicare & Medicaid Service (CMS) has approved eight new Recovery Audit Contractor [...]

Effective 9/8/20: AMA Issues 2 New COVID CPT® Codes

The American Medical Association (AMA) issued two new CPT® codes effective September 8, 2020.  The [...]

COVID-19 DRG with Enhanced Payments to be Audited

As part of the public health emergency CMS added increased weighted reimbursement to COVID-19 DRGs.  [...]

Specialty Care Transports (SCT): CMS Medical Necessity and Documentation Audits

Centers for Medicare & Medicaid Services (CMS) recently approved Recovery Audit Contractors (RACs) to audit [...]

The 2021 Proposed Physician Fee Schedule: The Major Points

On August 3 CMS published the proposed policy changes for the Physician Fee Schedule (PFS).  [...]

Home Infusion Billing Changes: What you need to Know

CMS announced several changes in Transmittal 10269 regarding billing home infusions effective January 1, 2021.  [...]

Inpatient Claim Audits in Center Focus with HHS-OIG

Inpatient audits once again take center stage with the Centers for Medicare & Medicaid Services [...]