In a $750,000 HIPAA Settlement, the University of Washington Medicine (UWM) has agreed to settle charges that it potentially violated the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Security Rule by failing to implement policies and procedures to prevent, detect, contain, and correct security violations.  UWM is an affiliated covered entity, which includes designated […]


Keyboarding Injury? ICD-10’s Got That Covered

The much delayed launch of ICD-10 code implementation finally occurred on Oct        1st, 2015. The new International Classification of Diseases, Revision 10 inflates coding options by the thousands and requires more specificity than ever before.

Among the standards, the new injury codes expanded to include some pretty crazy ways people have been injured […]

By |November 19th, 2015|ICD-10 Readiness|Comments Off on Keyboarding Injury? ICD-10’s Got That Covered

Final 2016 Medicare Physician Fee Schedule Released

The MGMA reports that the final 2016 Medicare physician fee schedule has been released.

The Centers for Medicare & Medicaid Services (CMS) finalized the Medicare physician fee schedule (PFS) for 2016.

Key policies finalized in the 2016 payment rules include:

Finalizing the Home Health Value-Based Purchasing model.
Finalizing updates to the “Two-Midnight” rule.
Finalizing the End-Stage Renal Disease Quality Incentive […]

By |November 7th, 2015|Medical Coding and Billing, Medical Practice Revenue Optimization|Comments Off on Final 2016 Medicare Physician Fee Schedule Released

ICD-10 Aftershocks: The Challenges Every CFO Can Expect

If any individual in the C-suite will feel the effects of ICD-10 most prominently, it will be the hospital CFO. As reported in Becker’s Hospital Review, October 2015, in a article by Kelly Whittle, MS, Principal, ICD-1 0 Advisory and Whittle Advisors, LLC, the top 4 issues faced by hospital CFO will include.

Significant productivity loss […]

By |October 28th, 2015|ICD-10 Readiness, Medical Coding Best Practices|Comments Off on ICD-10 Aftershocks: The Challenges Every CFO Can Expect

Now there’s 70,000 Ways to Classify Ailments

Doctors, insurers and hospitals are preparing themselves for possible business disruptions on Oct. 1. This is when ICD-10 hits, a massive new set of codes meant to describe any illness or injury.

Under ICD-10, cardiologists will have over 800 codes for describing angioplasty. Dermatologists will have 8 different types of acne. Gastroenterologists who aren’t sure what’s causing […]

By |September 29th, 2015|ICD-10 Readiness, Medical Coding News and Recent Articles|Comments Off on Now there’s 70,000 Ways to Classify Ailments

Holdup at the doctor’s office? New billing codes could be why.

Starting October 1st, physicians and hospitals will have to be far more specific than ever before when diagnosing problems from visits.

Because of this change to the system, called ICD-10, patients should expect longer than usual times to be billed for their portion. This may even add waits to the doctor’s office when visiting.

To both physicians […]

Medicare Reimbursement Rates Get a Small Increase

California Medical Association (CMA ALERT) – 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.

The increase to Medicare reimbursement rates is an effect of the Medicare Access and CHIP Reauthorization Act, signed in April 2015. CMS has released the […]

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

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. There had been concerns among providers that they wouldn’t be paid if they made minor mistakes trying to implement the new complex […]

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

In another instance of false claims to Medicare and Medicaid programs, Josh J. Minkler, United States Attorney, announced today a $20,324,902.22 civil settlement with Community Health Network (ACHN), a non-profit health system with more than 200 sites of care and affiliates throughout the State of Indiana.

You can read the full article on the website here […]

By |July 2nd, 2015|Medical Coding Audits and Compliance|0 Comments

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

A four-month Medicare fraud crackdown targeting ambulance service fraud has resulted in 11 New Jersey-based ambulance service providers relinquishing their licenses this year, according to the New Jersey Department of Health. However, as many as 20 to 25 companies reportedly have closed, remaining providers say. The Garden State costs Medicare more than any other state for […]