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Author "Michael Miscoe"

By Michael Miscoe
Feb 23rd, 2015
Comments Off on CMS Extends Deadline for Publishing Final Rule on Reporting/Returning Overpayments
The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule on February 12, 2012 implementing the provisions of Section 6402(a) of the Affordable Care Act (ACA), which outlined the requirements for reporting and returning overpayment...
By Michael Miscoe
Dec 2nd, 2014
Comments Off on Medical Necessity as a Fraud Theory
By Michael D. Miscoe JD, CPC, CASCC, CUC, CPCO, CCPC, CHCC The US Department of Justice recently announced settlement of False Claims Act 9 (FCA) allegations against Extendicare Health Services, Inc. (“Extendicare”) and its subsidiary Progressive St...
By Michael Miscoe
May 30th, 2014
Comments Off on Documentation and Coding Accuracy Concern
By Michael Miscoe, Esq. Here is an interesting story.  What is most notable is that the estimated total of “improper payments” is based on alleged coding and documentation deficiencies.  For the coding errors, is it that the code did not represent t...
By Michael Miscoe
In Billing
Jan 1st, 2014
Don’t crack under pressure to get physicians paid immediately; stay compliant if incident-to is a must. Recently, the question was asked, “Why couldn’t the services of the new (non-credentialed physician) be reported under the name of a credentialed ...
By Michael Miscoe
Apr 1st, 2008
Comments Off on Global Period: Reporting Subsequent Inpatient E/M Services Following Surgery
By Michael D. Miscoe, CPC, CHCC At the recent AAPC National Conference in Anaheim, I was asked an excellent question during ad-hoc networking. The question was, “Is subsequent inpatient E/M services or discharge evaluations following surgery within t...