Health Information Management

Healthcare News: CMS releases latest MLN Quarterly Provider Compliance Newsletter

JustCoding News: Inpatient, August 1, 2012

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CMS released its latest MLN Quarterly Provider Compliance Newsletter, volume 2, issue 4 in July.

The newsletter addresses common billing and coding errors, with the latest issue addressing frequently cited Recovery Auditors and Comprehensive Error Rate Testing (CERT) findings.
 
Specifically, readers will find more information on the following:
  • CERT finding:
    • Pressure reducing support surface claims
  • Recovery Audit finding:
    • Endocrine, nutritional, and metabolic disorders (services provided in a medically unnecessary setting)
    • Acute inpatient neurological disorders (medically unnecessary items or services provided in a medically unnecessary setting)
    • Cardiac arrythmia and conduction disorders with CC (inappropriate selection of principal diagnosis code)
    • Other circulatory system operating room procedures: MS-DRG 264
    • Pathological fractures
    • Urinary procedures
    • Gastrointestinal (GI) disorders
    • GI disorders (other digestive system diagnosis with MCC)
Click here to view additional issues of the quarterly newsletter.

 



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