If you work with risk adjustment coding, chances are you’ve seen some recent news from the Office of Inspector General (OIG) announcing findings for audits performed. OIG audits aren’t new, […]

A recent Office of Inspector General (OIG) report on Medicare’s utilization of one of the highest paid molecular pathology genetic tests caught my attention. You can read a summary of […]

As a clinical documentation integrity (CDI) and coding professional, I’ve often heard the statement: If it’s not documented, it wasn’t done. I have used this statement educating physicians and nurses […]

Audits of Hierarchical Condition Categories (HCCs) have been performed for years as a way for Part C vendors (Medicare Advantage Organizations) to identify and support patients with complex needs. Higher […]

Recently, I came across an OIG announcement “Review of Medicare Part B Claims for Intravitreal Injections of Eylea and Lucentis” released in June 2019. Upon reading this announcement, I pulled […]

I’ve been talking about this for years. I still see folks who don’t think compliance with medical necessity polices is critical. Believe me, I understand human nature; noncompliance can be […]

At AAPC’s annual Healthcon conference in Orlando, Florida, Dr. David Zielske (also known as Dr. Z) had a session on Interventional Radiology, Cardiology and Vascular Surgery coding. As you can […]

I review OIG updates as they are released and I saw something last week that unfortunately, I did not find surprising. Per the OIG report: “Payments made to providers for […]