High-Cost, High-Frequency Cases Challenge New Coders

Published: Tue, 12/11/18

Coders and auditors are taught to be diligent for the high frequency, high cost, and problem-prone cases as these topics are the focus on third-party reviewers. What does that mean for the new coder? The new coder may not be aware of what...

The Total Knee Arthroplasty Controversy Gets (Even More) Confusing

By this time last year, the Centers for Medicare & Medicaid Services (CMS) had notified providers that they were removing total knee arthroplasty (TKA) from the Medicare inpatient-only list. While the cries of disbelief and howls of frustration eventually died down after a few months, the remainder of 2018...

2019 ICD-10-CM Coding for Diabetes

November is National Diabetes Month, as well as Diabetic Eye Disease Awareness Month. Are you aware that diabetes is the leading cause of blindness among the working people of the United States? The 2019 ICD-10-CM Official Coding Guidelines state that if a type of diabetes is not...

CMS Paid $4M in Excess GME Medicare Reimbursement, OIG Finds

CMS did not have adequate procedures to ensure that hospitals did not count residents as more than one FTE when claiming GME Medicare reimbursement, audits showed.

Highlights of the Medicare Physician Fee Schedule Final Rule

There will be no change in E&M payment levels for 2019, as was proposed in the CMS proposed, rule, news that comes as a relief to many that expected to lose valuable...