DOJ Charges Hundreds With Opioid-Related Fraud
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The U.S. Department of Justice (DOJ) arrested 412 individuals, including 115 licensed medical professionals, across the country for alleged involvement in health care fraud schemes totaling around $1.3 billion in false billing and “unlawful” distribution of opioids and other narcotics, according to a statement. It is the largest health care fraud enforcement action ever taken by the
agency.
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Final ICD-10-CM Codes for 2018 Contain a Few Surprises
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The final codes include 322 more changes than what was proposed by CMS in April's hospital IPPS rule. Starting Oct. 1, it will be possible to select a specific ICD-10-CM code when a patient is in remission from abuse of each of a variety of substances, including alcohol, opioids, cannabis and nicotine
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How to Avoid TCM Coding Denials |
CMS began paying for TCM in 2013, and many commercial payers began doing so shortly thereafter. The 2017 national average Medicare payment for TCM with moderate medical decision making is $165.45. For TCM with high medical decision complexity, Medicare pays a national average of $233.99.
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Clinical Documentation Integrity: Where Business Acumen Governs High Performance |
Clinical documentation integrity (CDI) as a profession is quite similar in nature to running a business. Successful businesses exhibit certain operational qualities and traits that serve to ensure continued growth and prosperity, and their leaders possess a long-term vision and ability to consistently meet, exceed, and solidly predict current and future needs of their
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ICD-10: Abide By These Rules When Coding Foreign Bodies
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Foreign bodies (FBs) entering through one of the three ENT-specific pathways is a relatively common occurrence. While these situations are found primarily with children presenting for service, FBs of the ear, nose, and throat don’t necessarily discriminate when it comes to age. However, when it comes to coding, there are a few general rules to follow regardless of
circumstance:
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