RT Welter
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Healthcare Billing Fraud: 9 Recent Cases

The year may have just begun but healthcare billing frauds are already running rampant across the nation. Continue reading to learn about nine of the biggest billing fraud cases taking over the headlines. From Cincinnati-based Bon Secours Mercy Health agreeing to pay $1 million to settle allegations that it improperly billed Medicare, to a Florida…


Medical Decision Making: Drug Therapy Requiring Intensive Monitoring for Toxicity

There are often questions and confusion on what is included and acceptable when choosing “Drug therapy requiring intensive monitoring for toxicity” in the Medical Decision-Making Risk category for Evaluation and Management coding. This article reviews the definition and guidelines as provided by CMS and their Medicare Administrative Contractors (MACs). Risk: High MDM – Drug therapy…


Routine Medical Supplies Coverage and Guidelines

By: Sheila Haynes – Coding and Compliance Manager Correct coding and code definitions apply in all circumstances and to all provider types. Whenever a code is billed which includes another service or supply, whether by code definition or by coding guidelines, the included service or supply is not eligible for separate reimbursement. Supplies For Professional…