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ICD-10-CM Code

Laterality Frequently Unlocks ICD-10-CM Code Accuracy

To get your claims reimbursed, payers demand that you be as specific as possible with your ICD-10-CM code assignment. Often this means you must identify laterality and accurately adjust your coding to avoid claim denials and payer audits. When CMS implemented ICD-10, the number of diagnosis codes went from 14,000 to 68,000 — a massive jump. […]
Published Date: September 20, 2016
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MACRA Compliance

CMS Offers 4 Options for First Year MACRA Compliance

UPDATE: In response to CMS Acting Administrator Andy Slavitt’s Sept. 8 announcement that the agency would not delay MACRA implementation, leaders of the U.S. House Energy and Commerce Committee and Ways and Means Committee issued a statement Sept. 9 indicating that they were pleased that CMS was moving forward with options for compliance with the […]
Published Date: September 9, 2016
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60-Day Rule Timeline

Avoid Tripping Over the 60-Day Rule Timeline … Know When to Start the Clock

The relatively new 60-Day Rule affects all Medicare and Medicaid providers regardless of specialty, size or type, and nailing down the exact date to begin your 60-day countdown is one of the most confusing compliance aspects — although other rule components can easily trip you up as well. The rule may seem straightforward — you […]
Published Date: September 6, 2016
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HIPAA Breaches

HHS Targeting Smaller HIPAA Breaches

Beginning in August, the U.S. Health and Human Services Department (HHS) Office of Civil Rights (OCR) launched a new initiative to investigate smaller breach reports — meaning those that affect fewer than 500 individuals, the agency announced Aug. 18. This effort is based on a series of recent case settlements where OCR investigated smaller breaches […]
Published Date: August 30, 2016
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1,212 Injury Diagnosis Codes Changes

Make the 1,212 Injury Diagnosis Codes Changes Work for You

On Oct. 1, not only will your ICD-10 grace period end, but you also will have 1,212 injury code changes to comply with. That means you have no time to procrastinate, and you must ensure you’re ready … or you could be facing hefty denials. Almost every healthcare provider reports injury ICD-10 codes. And these […]
Published Date: August 23, 2016
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ICD-10 Test Claims Submitted

CMS Accept 89% of ICD-10 Test Claims Submitted

On June 2, 2014, CMS Acting Director, Niall Brennan, posted some exciting ICD-10 testing results to the CMS website. In summary, based on 2,600 participants, CMS accepted 89% of the more than 127,000 claims that were submitted with ICD-10 diagnoses. Brennan also posted that, “HHS expects to release an interim final rule….that would require the […]
Published Date: July 21, 2016
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Medicare Overpays

Medicare Overpays Billions on E/M Claims

According to a May 2014 report based on 2010 data, HHS is claiming Medicare overpaid $6.7 billion in E/​M payments to providers. The Inspector General’s report, released on May 29, 2014 estimates that 21% of the $32.3 billion spent on E/​M services in 2010 are overpayments.  This data is based on 657 Medicare claims. Although […]
Published Date: July 21, 2016
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Reduction in Your Medicare Reimbursement

Stop 1% Reduction in Your Medicare Reimbursement – You Still Have Time

The American Recovery and Reinvestment Act of 2009 (ARRA) requires Medicare providers that are not meaningful users of electronic health records (EHR) to start by taking a 1% pay cut as of January 1, 2015.  The payment adjustments will continue at 1% for every year if the provider is not a meaningful provider (maxing at […]
Published Date: July 21, 2016
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