Part B Insider (Multispecialty) Coding Alert
Physicians Pay Millions to Settle Allegations
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Fraud-busters saved Medicare and other federal healthcare programs $23 billion in 2003, over $1 billion more than the 2002 total and 117 times the amount spent, the HHS Office of Inspector General reports in its latest semiannual report.
Settlements included $1.6 million refunded by City of Hope Medical Center and City of Hope Medical Group, which paid up to settle claims that they didn't document physician supervision of care adequately. Also, a Wisconsin pathologist lost his state license after dispensing drugs via the Internet without first examining patients in person.
An internal medicine physician in Texas agreed to repay about $900,000 to settle claims he billed Medicare for services that weren't provided, weren't necessary, or weren't what he billed for.
Six physicians agreed to pay about $401,000 to settle charges they wrongly billed for free samples of the cancer drug Lupron. Physicians were also implicated in pharmacy and durable medical equipment fraud.
Part B Insider (Multispecialty) Coding Alert
- New Codes:
CPT 2004 Adds Codes for Two Otolaryngology Procedures
Sleep apnea coding won't keep you awake anymore
Otolaryngologists can rejoice - the 2004 update to [...] - HIPAA:
Carriers, Referral Sources Hoard Billing Information
Misunderstanding HIPAA leads to faulty bills
The Health Insurance Portability and Accountability [...] - Payers Follow CMS' Lead In Offering Contingency Plans
With a majority of providers lagging in compliance with the Health Insurance Portability and Accountability [...] - Venous Access:
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Understand the coding requirements for 36555-36597
Coders rejoiced when CPT Codes 2004 [...] - CPT Updates:
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Vaccine delivery codes revised for 2004
If your practice bills for multiple tendon sheath injections, CPT [...] - Billing:
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Find out what you can do to get paid for diagnostic tests
[...] - Fraud & Abuse:
Physicians Pay Millions to Settle Allegations
Fraud-busters saved Medicare and other federal healthcare programs $23 billion in 2003, over $1 billion [...] - Off-Label Drugs:
Medicare May Cover Unlisted Uses, But Expect to Back Them Up
Drug compendia, studies and documentation all may help gain payment
If your physician is prescribing drugs [...] - Physician Notes:
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The U.S. Senate approved the most dramatic overhaul of the Medicare program since its inception.
The [...]