In Audit
Aug 15th, 2017
Effective June 15, 2017, the Office of Inspector General (OIG) now updates its Work Plan website monthly. The OIG Work Plan sets forth various projects — including OIG audits and evaluations that are underway or planned — to be addressed during the fiscal year and beyond by OIG’s Office of Audit Services and Office of ...
In CMS
Aug 10th, 2017
The Office of Inspector General (OIG) says noncompliance of the three-day rule continues to cost Medicare millions of dollars, every year. In 2013-14, National Government Services (NGS), alone, reportedly overpaid New England providers an estimated $1.3 million. This estimate is based on a stratified random sample of 129 nonphysician outpatient services furnished within three days ...
Payers vary on documentation and coding requirements for telehealth services. The rules for documenting and coding telehealth services are a patchwork. Guidelines for Medicare payers, although evolving, are well established. Private payer rules vary depending on the insurer, the patient’s individual plan, and the state where the services are rendered. Regardless of payer, you’ll need ...
The OIG has their eyes open for medical necessity of these diagnostic studies. By Karla Grimwood, MS, CPC, CPMA, CEMC A provider must keep in mind several things to support compliant coding for diagnostic sleep studies. And the pressure is on: The Office of Inspector General (OIG) has included sleep studies on its annual Work ...
In Coding
Aug 1st, 2017
Perfect coding isn’t hard if you follow the rules — give it a shot. August is National Immunization Awareness Month (NIAM). According to the Centers for Disease Control and Prevention (CDC), “NIAM was established to encourage people of all ages to make sure they are up to date on the vaccines recommended for them.” Here’s ...