Health Information Management

News: CMS issues latest quarterly provider compliance newsletter

CDI Strategies, May 12, 2011

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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 were the three issues of concern for inpatient hospitals listed in the latest edition of CMS’ Medicare Quarterly Provider Compliance Newsletter.

The newsletter, published by the Medicare Learning Network (MLN), offers providers guidance on avoiding common Medicare billing and general errors typically identified as the major findings of government auditors and contractors such as Recovery Auditors, Program Safeguard Contractors, Zone Program Integrity Contractors, and others organizations such as the Office of Inspector General. Each quarterly issue is intended to help facilities understand the claims submission problems and how to them. Other concerns identified in this edition include matters pertaining to inpatient rehabilitation facilities, radiology suppliers, and outpatient hospitals.



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