Inpatient hospital entitlement changes
When a patient enrolls in or disenrolls from a Medicare Advantage plan during his/her inpatient stay, the following factors will...
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Reporting manifestation diagnosis codes
The January Integrated Outpatient Code Editor (IOCE) expands editing related to manifestation diagnosis codes. Read this article...
Behavioral health services
Medicare covers behavioral, mental and psychiatric health services that may improve outcomes for Medicare patients. For more...
End-stage renal disease (ESRD) monthly capitation payment (MCP) claims
Billing ESRD monthly capitation payment claims correctly is important. Read this article to learn more about billing these...
Skilled nursing facility (SNF) no-payment claims
Read this article to learn more about billing skilled nursing facility (SNF) no-pay claims.
Skilled nursing facility sequential billing
Read this article to learn more about skilled nursing facility (SNF) sequential billing.
Potential assignment violations by clinical laboratories
Some clinical laboratories in our jurisdiction are charging patients prior to performing services, a potential assignment...
Recommendations regarding the development of a model compliance plan for clinical laboratories
The Office of the Inspector General (OIG) and other federal agencies have emphasized the importance of voluntarily developed and...
Cardiac and pulmonary rehabilitation programs
Medicare pays for cardiac rehabilitation (CR), intensive cardiac rehabilitation (ICR), and pulmonary rehabilitation (PR)...