With the news that CMS has started conducting pre-payment audits to monitor meaningful use payments, some providers have been worried about what it means if they get a letter in the mail. Below, Rob Anthony, Deputy Director of the HIT Initiatives Group, Office of...

T88.4xxA - Failed or difficult intubation, initial encounternnT42.5X6A - Underdosing of antiepileptics, initial encounternnT82.515A - Mechanical breakdown of cardiac umbrella device, initial encounternn nnIn preparation for the upcoming deadline for ICD-10...

Saturday:nL55.9 – SunburnnR61 – SweatingnW29.3xxA – Contact with powered garden tools, initial encounternTuesday:nT33.90 – FrostbitenX37.2xxA – Injury due to blizzard, initial encounternW29.8xxA – Contact with snow shovel, initial encounternnIn preparation for the...

To All Health Care Professionals, Providers, and Suppliers:nMandatory Payment Reductions in the Medicare FFS (Fee-for-Service) Program – “Sequestration”nThe Budget Control Act of 2011 requires, among other things, mandatory across-the-board reductions in Federal...

Medicare PECOS Edits Begin May 1, 2013 - Claim Denials PossiblenEffective May 1, 2013, the Centers for Medicare & Medicaid Services (CMS) will turn on the Phase 2 denial edits. This means that Medicare will deny claims for services or supplies that require an...

J30.1 – Hay fevernnJ30.81 – Rhinitis due to animal dandernnJ30.2 – Seasonal allergiesnnJ30.89 – Rhinitis due to feathersnnL23.7 – Allergic Dermatitis due to plantsnnIn preparation for the upcoming deadline for ICD-10 implementation, Welter Healthcare Partners presents...

W61.33xA – Pecked by Easter chick, Initial EncounternnT62.8x1A – Food Poisoning, accidental, Initial Encounter, old hard-boiled Easter EggnnF40.218 – Easter Bunny Phobiann nnIn preparation for the upcoming deadline for ICD-10 implementation, Welter Healthcare...

CAQH recently launched a new solution to enroll in EFT with participating payers through a universal process! Enrollment is easy!nnUsing CAQH's EFT Enrollment utility, providers can securely enroll in electronic payment programs with payers. The site streamlines...

On March 13, 2013, the Centers for Medicare & Medicaid Services (CMS) issued a ruling contrary to its traditional billing policy regarding payment of Part B inpatient services following denial of a Part A claim. Ruling CMS-1455-R came about in response to an...

Health care providers are REQUIRED to complete Compliance Certification! The Centers for Medicare & Medicaid Services (CMS) requires that all Humana business partners, including health care providers, complete required compliance training and...

In what appears to be a shift in policy, the Centers for Medicare & Medicaid Services has begun auditing providers attesting to Meaningful Use of their electronic health record systems before doling out incentive payments, according to a report from the American...

Be on the lookout! Humana staff members regularly conduct medical record audits in randomly selected physician offices to help satisfy regulatory compliance by evaluating physician compliance with adopted medical record documentation guidelines. The minimum passing...