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Physician Coding Errors Led to Millions in Overpayments For Stroke Patients, Says OIG

Posted by David Fong on Sep 29, 2020 10:00:00 AM

A report from the U.S. Department of Health and Human Services' Office of Inspector General (OIG) earlier this month found improper physician coding of stroke patients who were transferred from traditional Medicare to Medicare Advantage, which led to overpayments of an estimated $14.4 million. The OIG found nearly all of the selected acute stroke diagnosis codes that physicians submitted to CMS under traditional Medicare that CMS later used to make payments to Medicare Advantage organizations didn't comply with federal requirements.

 

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Topics: Medical Coding, Medical Coding Audits, Pro-Fee Coding, Outpatient Coding, COVID-19

Hospital Financial Performances Starting to Recover As Providers Increasingly Consider Outsourcing

Posted by David Fong on Aug 31, 2020 7:45:00 AM

While hospital financial performance is starting to recover after experiencing historic lows at the start of the COVID-19 pandemic, providers still face a bumpy road ahead, according to experts at Kaufman Hall. Comparing July 2020 to June 2020, hospital operating margins increased 24 percent. Operating EBITDA margins also increased by 12 percent month-over-month and were 9 percent above budget without the financial aid despite falling by 5 percent year-over-year, the firm reported.

 

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Topics: Medical Coding, Pro-Fee Coding, Facility Coding, Outpatient Coding, COVID-19

Medicare Payment Rates Announced for COVID-19 Test CPT Codes

Posted by David Fong on May 22, 2020 9:30:00 AM

More than 10 million COVID-19 laboratory tests have been conducted in the United States thus far. While the US testing per capita rate still lags behind several other countries, the number of tests completed continues to rise. These tests are medical coded and reimbursed just like other medical procedures. The CPT codes announced in March and April when testing became prevalent in the United States now have associated Medicare MAC payment rates.

 

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Topics: ICD-10, Medical Coding, Pro-Fee Coding, Facility Coding, Outpatient Coding, COVID-19

Telehealth Usage Skyrocketing During This Pandemic

Posted by David Fong on Apr 23, 2020 9:30:00 AM

Telehealth usage is skyrocketing during this COVID-19 pandemic, as the way people interact with each other and their healthcare providers change. The increased demand in remote video technology, or in its absence telephony, for clinical interactions has led to changes in how providers offer patient care, as well as led to changes in reimbursement policies enacted and enforced by the federal government.

 

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Topics: ICD-10, Medical Coding, Pro-Fee Coding, Facility Coding, Outpatient Coding, COVID-19