In an effort to provide helpful information to providers, CMS has released a special edition MedLearn Matters (MLN) article that disseminates diagnosis-related group (DRG) coding vulnerabilities for ...

In the largest Medicare Advantage fraud settlement to date, Oakland, Calif.-based Kaiser Permanente agreed to pay $556 million to resolve allegations it violated the False Claims Act by submitting ...

Hospitals overbilled Medicare $1 billion by incorrectly assigning severe malnutrition diagnosis codes to inpatient hospital claims, according to a report from HHS’ Office of Inspector General. The ...

Effective April 1, 2020 through September 30, 2020, a new diagnosis code U07.1 was added to the ICD-10-CM code set for the novel coronavirus COVID-19: U07.1. The ICD-10-CM Official Coding and ...

Don't code hospital records prematurely, warns Donna Wilson RHIA, CCS, CCDS, senior director at Compliance Concepts, Inc. Wilson's advice follows a recent article from The Centers for Medicare & ...

Diagnosis-related group coding determines eligibility for many Medicare bundled payment initiatives. This approach excluded many patients with chronic obstructive pulmonary disease likely to benefit ...

Inpatient hospital stays have become more expensive to the Medicare program. It's a trend that began even before the COVID-19 pandemic. A new report from the Department of Health and Human Services' ...

Ambience Healthcare rolled out an ICD-10 clinical document integrity assistant for inpatient care, aiming to help hospitalists document more accurate clinical notes and reduce billing and coding ...

If a viral test is performed more than 14 days prior to a patient’s admission, CMS will consider whether there are complex medical factors in addition to the test result. Inpatient novel coronavirus ...