In CMS
Jan 15th, 2019
Every year, the Centers for Medicare & Medicaid Services (CMS) updates their Designated Health Services (DHS) Code List. What are designated health services, and why should you care? The Link to Designated Health Services and the Law By law, CMS categorizes the following as designated health services: Clinical laboratory services Physical therapy services Occupational therapy services ...
In Audit
Nov 29th, 2018
A 5-year demonstration to develop improved procedures for the identification and prosecution of potential Medicare fraud occurring in the Home Health Program will begin in Illinois no sooner than Dec. 10, pending Congressional approval. The Centers for Medicare & Medicaid Services (CMS) will conduct the Review Choice Demonstration for Home Health Services in Jurisdiction M, ...
In the absence of payer guidance, look to CMS and CPT® for guidance on reporting an E/M as a separate service from chiropractic manipulative treatment with modifier 25. Editor’s Note: Healthcare Business Monthly was recently asked about reporting evaluation and management (E/M) services separately from chiropractic manipulative treatment (CMT) of the spine. As with most ...
In Billing
Sep 28th, 2018
Health Management Associates, LLC (HMA), a hospital chain that has its headquarters in Naples, Florida will be paying over $260 million to avoid criminal and civil claims associated with a scheme to defraud the government of the United States. In this case, the government alleged that HMA was billing inpatient services when they should have ...
In CMS
Sep 11th, 2018
The Centers for Medicare & Medicaid Services (CMS) knows there is a lot of administrative overhead when submitting medical claims for payment. To help you navigate through the red tape, CMS has created a “Administrative Simplification Basics Series,” where you can Sign up for Administrative Simplification email updates. The series helps the healthcare community use electronic ...