Sixty-one percent of 300 randomly selected Medicare claims for outpatient physical therapy services submitted over a period of six months did not comply with Medicare medical necessity, coding, and/or documentation requirements, according to a March 2018 audit from the Office of Inspector General.
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News
Roughly 25% of healthcare money used for the billing process, JAMA study finds
Source: ACDIS
A recent study by JAMA found that roughly 25% of healthcare dollars are used for the administrative billing process, not patient care.
OIG: CMS paid $367 million for noncompliant outpatient physical therapy
Source: Revenue Cycle Advisor
Sixty-one percent of 300 randomly selected Medicare claims for outpatient physical therapy services submitted over a period of six months did not comply with Medicare medical necessity, coding, and/or documentation requirements, according to a March 2018 audit from the Office of Inspector General.
 

Revenue Cycle Advisor Subscriber Content

HIPAA Q&A: Notice of Privacy Practices, psychiatric notes, and disposing of PHI
Source: Revenue Cycle Advisor
This month's HIPAA Q&A answers readers' questions about Notice of Privacy Practices, psychiatric notes, and disposing of PHI.
 

Daily Q&A
Q&A: Resolving PTP edits
Source: Revenue Cycle Advisor
Q: What are some guidelines for resolving procedure-to-procedure edits?

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Upcoming CMS Events
Tuesday 3/27 - Drug Manufacturers: New System to Report ASP Data for Part B Drugs Call
Wednesday 3/28 - The IMPACT Act and Improving Care Coordination
Wednesday 4/11 - Spinal Orthoses Referring Providers Comparative Billing Report Webinar
Tuesday 4/24 - CMS National Provider Enrollment Conference
 

Product Spotlight

Clean Up Wound Care Coding, Reduce Audit Risk: 2018 Coding and Guideline Updates

During this 90-minute webinar, coding expert Gloria Miller, CPC, CPMA, CPPM, will review the latest ICD-10-CM codes and coding guidelines applicable to wound care services. She will also explain how to find available medically unlikely edits (MUE) for certain procedures and proper application of the -X{EPSU} modifiers and modifier -59.
 

    

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Conquering the complexity of integrated care management

Learn how a health system is changing the culture toward more effective and efficient care coordination for the health system’s sickest patients.
 
 

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