In Billing
Feb 19th, 2018
Effective Jan. 1, 2018, newly approved biosimilar biologicals with a common reference product are no longer grouped into the same billing code. This change was finalized in the 2018 Medicare Physician Fee Schedule final rule. Q5102 Replaced with Two New Codes The April 2018 update to the Medicare Physician Fee Schedule Database (MPFSD) includes three ...
Accurate coding and better documentation can help raise red flags when patient abuse is present. The U.S. Department of Health and Human Services (HHS) reports that drug overdose deaths are the leading cause of injury death in the United States; and each year, drug abuse causes millions of serious illnesses or injuries across America. Commonly ...
In CMS
Jul 13th, 2017
The Office of Inspector General’s (OIG) combat on healthcare fraud, waste, and abuse of taxpayer’s money recovers $5 for every $1 spent on investigating, which gives them incentive to target more areas of fraud. The OIG’s latest and largest fraud takedown happened this month when opioid fraud was exposed with the help of state and federal law ...
Apr 4th, 2017
In an ongoing effort to strengthen the Medicare Advantage and the Prescription Drug Program by supporting flexibility, efficiency, and innovation, the Center Medicare & Medicaid Services (CMS) released final updates to the Medicare Advantage and Part D Prescription Drug Program for 2018. The final policies are similar to the proposal released in February’s 2018 Advance Notice ...
In Billing
Feb 3rd, 2017
The Centers for Medicare & Medicaid Services (CMS) has released the files containing the payment amounts for Part B covered drugs for the first quarter of 2017. Medicare Part B payment limits for valid HCPCS codes that are not included in the quarterly pricing files will be determined by local Medicare contractors. Comparing the first ...