Feb 13th, 2018
Aetna is under investigation in California for allegedly not following protocol when making coverage decisions. One Aetna member, Gillen Washington, 23, claims it nearly cost him his life. Washington is suing Aetna for breach of contract and bad faith, according to CNN. Case for the Plaintiff Washington, who has common variable immunodeficiency (CVID), claims Aetna ...
In Billing
May 1st, 2014
They share their journeys of breast cancer diagnoses. By Freda Brinson, CPC, CPC-H, CEMC, I’d like to share with you the real experiences of two women diagnosed with various types and stages of cancer. I hope you find their true stories insightful and inspiring. Susan Thirty-three-year-old Susan—wife, mother, sister, daughter, friend, and full-time apartment manager—noticed changes ...
Sep 1st, 2011
Determine whether 96372 or 96401 is the correct code to use. By G.J. Verhovshek, MA, CPC Several threads in an AAPC online forum, as well as inquiries from Coding Edge readers, have questioned whether 96372 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular or 96401 Chemotherapy administration, subcutaneous or intramuscular; non-hormonal ...
In CMS
Jul 2nd, 2009
The Office of Inspector General (OIG) is recommending the Centers for Medicare & Medicaid Services (CMS) do more to ensure Medicare Part B claims for chemotherapy administration services are appropriate. This recommendation was prompted after the OIG was unable to determine whether Medicare appropriately paid for Part B services billed as chemotherapy administration from 2005 to ...