TCN Medical Coding Blog

Medicare Reimbursement Rates Get a Small Increase

Jul 16, 2015
The CMS announced that a 0.5% increase will be made for Medicare reimbursement rates, which are effective starting July 1, 2015 to December 31, 2015.

CMS will reimburse ICD-10 mistakes for one year after transition deadline

Jul 07, 2015
For one year past the Oct. 1, 2015 deadline, the CMS will reimburse for wrongly coded claims as long as that erroneous code is in the same broad family as the right one

US Attorney’s Office Recovers Over $20 Million Dollars Against Community Health Network

Jul 02, 2015
Josh J. Minkler, United States Attorney, announced today a $20,324,902.22 civil settlement with Community Health Network (ACHN) regarding false claims to Medicare and Medicaid programs.

Medicare Fraud - Taken For a Ride By Ambulance Companies in New Jersey

Apr 15, 2015
The Garden State costs Medicare more than any other state for ambulance rides per kidney dialysis patient. A new crackdown is set to start, but at one big dialysis center, ambulances remain everywhere.
Posted in:

Government Recovers $3.3 billion in Fiscal 2014 Federal Health Program Fraud

Mar 19, 2015
A sign above the boarded-up Riverside General Hospital Wellness Center in Houston last year. The former president of Riverside Hospital and three other employees were convicted in a Medicare scheme to steal $158 million from the federal government. PHOTO: ASSOCIATED PRESS

New “X” Modifiers and Impact to UnitedHealthcare Commercial Reimbursement Policies

Jan 18, 2015
New "X" Modifiers and Impact to UnitedHealthcare Commercial Reimbursement Policies

Is Physician Fear of ICD-10 Turning Them Off Preparation?

Jan 18, 2015
Does ICD-10 have physicians running scared? How can the industry respond to their needs and concerns to ensure a successful switch?
Posted in: ICD-10 Readiness,

Medicare Outreach Article - Modifier -59 Could Impact Reimbursement

Jan 06, 2015
Change Request (CR) 8863notifies MACs and providers that the Centers for Medicare &
Medicaid Services (CMS) is establishing four new HCPCS modifiers to define subsets of
the -59 modifier, a modifier used to define a “Distinct Procedural Service.”

CMS Final Payment Rules Focus on Value, Quality, and Transparency

Dec 29, 2014
CMS released final rules outlining how Medicare will pay healthcare providers and suppliers in 2015. According to an October 31 CMS News press release, “The rules reflect a broader Administration-wide strategy to move our health care system to one that values quality over quantity and spends taxpayer dollars more wisely by finding better ways to deliver care, pay providers, and distribute information.”

New Medicare Rules Aim to Reduce Suspicious Billing Abuse

Dec 06, 2014
Announced in the Wall Street Journal on Dec 3, 2014, the Obama administration has strengthened Medicare’s authority to kick doctors and other medical providers out of the federal program for abusively billing the government.