Recovery Audit Contractors (RAC) reported doubled its recovery amounts since last quarter—$167 million in denials during the first quarter of 2011 up from $86 million reported during the last quarter of 2010,...Read More »
A mandate of the Affordable Care Act, CMS’ value-based purchasing (VBP) program will begin in fiscal year 2013, applicable to discharges occurring as of October 1, 2012, according to the program final rule and...Read More »
Nearly 500 healthcare quality professionals indicated that staffing shortages could be the biggest issue facing quality initiatives in the US, according to a poll from the American Society for Quality (ASQ) released May 3.
Improper coding of MS-DRG 813 (coagulation disorders), reporting an extensive operating room procedure unrelated to principal diagnosis (MS-DRGs 981,982,983, formerly DRG 468), and reporting the wrong diagnosis code or wrong principal diagnosis code for human immunodeficiency virus (HIV) disease...Read More »
Hospitals can start experimenting with how new ICD-10-CM/PCS codes will translate to MS-DRGs since CMS released its MS-DRG Version 28 Definitions Manual. ICD-10 is expected to map similarly to ICD-9; meaning when coders...Read More »
Since the inception of the permanent recovery audit contractor (RAC) program, government auditors have identified claims errors in excess of $350—$313.2 million of which were identified as overpayments and recouped by the government. ...Read More »
In response to President Barack Obama’s January 18 executive order aimed at reducing federal regulatory burdens, the American Medical Association (AMA) conducted a survey of its members seeking their input on the issue. More than 2,000 physicians responded. Of these, three out of five of named...Read More »
