In Audit
Nov 1st, 2018
By law, the Administrative Law Judge level of Appeals has 90 days to resolve appeals submitted to the ALJ level.  However, the Department of Health and Human Services (HHS) Office of Hearings and Appeals (OMHA) has been unable to keep up with the number of appeals submitted to them which has lead to a huge ...
In Audit
Oct 2nd, 2018
If you are a particularly observant medical coder, you’ve probably noticed that many codes identified as deleted were actually promoted to new roles. Nearly 50 codes were revamped to become parent codes of more specific codes,and it’s causing some confusion because some electronic coding systems mark them as deleted AND new. Same Codes Marked as Deleted/New Take ...
In Audit
Sep 28th, 2018
The Centers for Medicare & Medicaid (CMS) is releasing the Quality Payment Program (QPP) computer code responsible for calculating quality measures from Medicare claims data submitted by eligible clinicians via Quality Data Codes (QDCs). This code is intended for developers interested in the calculation mechanism supporting QPP Claims to Quality. If QPP is part of your ...
Sep 21st, 2018
The healthcare industry is a fast-paced, ever-changing business that never rests. Perpetual changes to federal regulations, code sets, and technology make it nearly impossible to stay up to date. But stay up to date we must to ensure compliance and receipt of proper reimbursement for healthcare services and supplies. If only there was one place you could turn to ...
Become an expert in identifying, correcting, and preventing denials. Denied claims are as common and predictable as having a child spike a fever before a big holiday, and every practice or group finds itself wrestling with corrections and resubmissions. But if you ask AAPC’s Director of Curriculum Katherine Abel, CPC, CPB, CPMA, CPPM, CPC-I, AAPC ...