Medicare Compliance & Reimbursement - eNewsletter

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Medicare Compliance & Reimbursement Alert – an AAPC eNewsletter

The Centers for Medicare & Medicaid Services (CMS) is committed to reducing improper payments and has cut error rate numbers again this year. What does this mean for your organization? Expect ongoing scrutiny for CERT-identified errors.

But CMS isn’t your only concern. The OIG has expanded its scrutiny of telehealth services and COVID fraud while OCR continues to levy heavy penalties for HIPAA Right of Access violations.

Stay Informed, Liability-Free, and Safeguard Your Medicare Revenue

Work smarter with play-by-play guidance on CMS rollbacks and program revisions — as well as HIPAA, OIG reports, MAC and RAC activities, the QPP, and more — with your bi-monthly subscription to Medicare Compliance & Reimbursement Alert.

Our team of experts will keep you up to speed on regulatory changes and revisions across the various parts of Medicare from new rules, codes and guidelines, modifiers, fee schedules, and more.

Every issue of this indispensable resource is packed with how-to guidance to help you eliminate your workload and optimize your Medicare pay.

6 Reasons to Subscribe to Medicare Compliance & Reimbursement Alert

  • At-a-Glance Tools: Access clip-and-save checklists and cheat sheets covering everything from POS coding and ICD-10 advice on hurricanes to the spectrum of HIPAA Security Rule and Privacy Rule components.
  • Online Convenience: Search thousands of Medicare Compliance & Reimbursement Alert articles to access strategic insights stored in our online archive dating back to 2003.
  • Timesaver: Stay on top of ever-changing regulations and industry developments without having to search the internet. The information your staff needs is delivered to you in Medicare Compliance & Reimbursement Alert.
  • Practical Explanations: Say goodbye to obscure legal rhetoric. Find guidance written in everyday language on all the issues impacting your organization.
  • Always In-the-Know: Keep your finger on the pulse of CMS’ proposals and rules, health IT, and industry changes with 24 e-Newsletter issues in your annual subscription, each designed to ensure you’re prepared to comply with the latest regulatory reform.
  • Earn Annual CEUs: Keep your Medicare compliance and coding know-how current and earn 6 CEUs, free with your e-subscription. CEUs may be applied toward maintaining any credential except CIRCC. Note: A CEU quiz will be offered with every other issue of Medicare Compliance & Reimbursement.

Newsletters are regular and timely publications written by subject matter experts with their fingers on the pulse of your industry.

In the case of coding newsletters, your subscription will give you all the latest information you need, plus a refresher on things you might have learned but forgotten.

Coding newsletters feature real reader questions, interviews, and guidance from experts. You’ll find clinical scenarios and expert advice to explain code choice and guide you through the code selection process. A specialty-specific newsletter promotes accurate coding, leading to higher revenues and less time and money wasted on justifying billing.

Non-coding healthcare newsletters provide up-to-the-minute news on changes in federal regulations governing reimbursement and legislative developments. You’ll find ways to navigate often dense government-speak and learn how to apply regulatory changes to your practice or agency.

The knowledge disseminated in each newsletter issue can help protect your practice or business from costly mistakes and even help boost your revenue with guidance on the best ways to:

  • Code challenging scenarios or use modifiers correctly
  • Stay on top of the latest news and regulatory changes pertaining to the healthcare market
  • Learn how to ethically optimize your reporting to avoid undercoding and missed opportunities

Healthcare Business Monthly is a broad-scope publication that provides information on a range of topics, including human-interest stories based on coders. It also covers healthcare issues beyond coding, compliance, or post-acute care — such as front-desk etiquette, keeping the office clean, etc.

Coding newsletters, more focused than Healthcare Business Monthly, exclusive cover coding, billing, and regulations for the title specialty.

Non-coding healthcare newsletters dig into the regulatory news pertaining to healthcare. These are up-to-the-minute publications. You won’t find such in-depth information for compliance, practice management, MDS, home health, or hospice in Healthcare Business Monthly.

AAPC coding newsletters will help new coders get up to speed on the job. The articles cover several in-specialty topics each month and delve into the specifics of coding procedures and services. A new coder could get information on a coding scenario in a newsletter before they encounter it in the workplace, which is a huge asset.

Coding newsletters provide more exposure to the news you need, and the quizzes offer an opportunity to apply your coding knowledge in a low-stakes situation. Newsletter articles and reader questions add to and reinforce coder training. You’ll find expert opinions and advice from trusted and experienced sources that can help you understand the nuances of the profession.

Throughout the year, all newsletters contain updates to codes and coding guidelines that are vital to new and veteran coders. From articles on code changes and quarterly National Correct Coding Initiative (NCCI) edits to discussions of ad-hoc guideline changes issued by CMS and other agencies, newsletters keep coders informed and current. Having a specialty-focused publication addressing and analyzing updates is an important tool for every coder.

For instance, NCCI edits are often applied behind the scenes to coding software, and coders may be staring at a denial without realizing why. Newsletter articles will update coders to the edits that affect their practices the most and translate them into practical advice. That way, even veteran coders will be aware.

Secondly, there is so much to remember in coding that everyone occasionally forgets how to report something. The newsletter provides a monthly refresher on coding topics that a veteran coder might not have seen in a while.

Finally, most AAPC coding newsletters provide coders with regular AAPC CEU opportunities that can help keep your credentials current.

CPT® is a registered trademark of the American Medical Association. All rights reserved.

Most coding newsletters are specific to a medical specialty, and coders working in those specialties should obviously subscribe to newsletters aligned with their professional interests.
Several newsletters feature subject matter that crosses specialty lines. E/M Coding Alert, ICD-10 Coding Alert, and Health Information Compliance, for example, all contain articles and reader questions applicable to most specialties, practices, and institutions.

You’ll also find newsletters dedicated to compliance, practice management, skilled nursing facility, home health, hospice, and Medicare Part B. These newsletters are beneficial to practice managers, billing/coding staff, Minimum Data Set nurses, clinicians, and administrators.


eNewsletter Title


Medical Coding

Anesthesia Coding Alert


Cardiology Coding Alert


E/M Coding Alert


ED Coding Alert


Gastroenterology Coding Alert


General Surgery Coding Alert


ICD-10 Coding Alert


Neurology and Pain Management Coding Alert


Neurosurgery Coding Alert


Ob-gyn Coding Alert


Oncology/Hematology Coding Alert


Optometry/Ophthalmology Coding Alert


Orthopedic Coding Alert


Otolaryngology Coding Alert


Path/Lab Coding Alert


Pediatric Coding Alert


Podiatry Coding and Billing Alert


Primary Care Coding Alert


Pulmonology Coding Alert


Radiology Coding Alert


Urology Coding Alert



Health Information Compliance Alert


Medicare Compliance & Reimbursement


Part B Insider


Practice Management Alert



Home Care Week


Hospice Insider


MDS Alert


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If you are not an existing Codify customer, you will receive your login credentials when you purchase your eNewsletter subscription.

AAPC newsletters are all available in full-color electronic format. The “flipbook” format functions like an online magazine. You’ll be able to click on live links in articles to go directly to resource websites, and you can do keyword searches of the newsletter.

Articles in an eNewsletter can be downloaded to your computer and then printed.

Newsletters monthly issue date varies from month to month. Different newsletter may or may not be published on the same date of the month.

Fees paid for any subscription term are paid in advance and are not refundable in whole or in part. You may terminate your subscription at any time and continue using the services until the expiration of your pre-paid term.

How to Cancel: You may terminate your subscription by contacting AAPC via phone or email. To ensure that your credit card does not get charged, please make your cancelation request at least two business days prior to the end date of your subscription term.

You will not be able to log in to your account to view a newsletter once your subscription expires. If you decide to end your subscription but would like to refer to past articles, you should download the articles prior to the expiration of your subscription.

Warning: Be aware of restrictions and rules to avoid OIG censure. If you need to connect with your patients for telehealth purposes — but they don’t have an iPhone to connect with you — fresh OIG guidance may brighten your day. Read on for the news. Details: In Advisory Opinion 22-08 posted last month, the HHS Office of Inspector General [...]

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Hint: Check documentation rules before submitting claims. If you care for Medicare beneficiaries, advance care planning (ACP) is likely on your radar or at the very least something you’ve discussed with your terminally ill patients. However, even if you bill for ACP services, you may not know how the CPT® guidelines factor into the claims equation See if you can [...]

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Tip: Documentation is key. When employed properly, 99211 can allow certain qualified professional staff in your practice to handle low-level E/M visits. This allows physicians to focus on higher-complexity patients and helps your office run smoothly. If you understand how to use it, the established patient office evaluation and management (E/M) code 99211 (Office or other outpatient visit for the [...]

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Tip: Review QPP updates as terminologies and policies evolve. Whether you’ve been submitting quality data to Medicare for years or you’re new to the Quality Payment Program (QPP), there are a few items that every MIPS-eligible clinician should know. Reminder: The Centers for Medicare & Medicaid Services (CMS) nixed the Sustainable Growth Rate (SGR) law in 2015 as mandated by [...]

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Caution: Revisit the incident-to rules before billing ACP services to Medicare. After you’ve answered the quiz questions on page 3, check your responses with the ones below: Answer 1: The descriptor for 99497 (Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other [...]

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Question: We find the Medicare billing process a bit confusing and aren’t sure what to include on our claims pertaining to our beneficiaries’ diagnoses. When preparing a claim, should we enter the diagnosis code only for the condition the physician is treating? Or should we list all the current conditions that the patient is experiencing? Ohio Subscriber Answer: The answer to this [...]

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