Community Hospital in Munster, Indiana, is disputing an Office of Inspector General (OIG) report that found DRG assignment errors and incorrect inpatient rehabilitation facility (IRF) claims, resulting in an projected $22,051,602 in overpayments.Read More »
CMS is seeking comments on a proposed coverage with evidence development for chimeric antigen receptor T-cell (CAR-T) therapy for relapsed or refractory cancer when prescribed by the treating oncologist.Read More »
NAHRI is seeking healthcare professionals to speak at its annual Revenue Integrity Symposium to be held October 15–16, 2019, at the Renaissance Orlando. Speaking at RIS is a great way to expand your professional horizons as it can help hone your speaking skills and make lasting connections with...Read More »
Q: We recently had a consultant recommend that we create evaluation and management (E/M) levels for our labor and delivery observation cases, similar to our emergency room levels. Does anyone do this? If so, would you be willing to share your criteria and logic used?Read More »
The improper payment rate for routine venipuncture lab tests was 16.3% in 2018, representing more than $20 million, and medical necessity errors accounted 98.9% of the improper payments, according to CMS.Read More »
CMS recently reissued Special Edition MLN Matters 19002 to address lingering provider questions surrounding the application of the 2-midnight rule to total knee arthroplasty (TKA) claims. The MLN Matters article was originally released January 8 but was reissued January 24 to...Read More »
