The Benefits of DRG Validation

DRG validation is a tool that can be used to reduce risk, defend claims, and ensure the accuracy of the coded items. The purpose of DRG validation is to confirm that diagnostic, procedural information, and the discharge status of the beneficiary, as coded and reported...

Fraud Waste and Abuse Fact: August

DOJ and HHS Annual Report Highlights $3.3 Billion in Settlements and Judgments in FY 2014 “On March 19, 2015, the Department of Justice (DOJ) and Department of Health and Human Services (HHS) issued their annual Health Care Fraud and Abuse Control (HCFAC) Program...

Medicare Guidance for Mid-Level Providers

Taking the Guesswork out of Correct Billing More and more health organizations are hiring midlevel providers to perform services that were formerly thought to be appropriate exclusively for medical physicians. While it is less costly to hire Physician Assistants,...

Chiropractic Coding

Many years ago when I first began my career in the health field I worked for a chiropractic office as I was becoming familiar with their computer system, codes, and billing forms I had a lot of questions! Over 15 years, work on a bachelors degree and multiple coding...

You Be The Coder: August

What would the correct CPT code assignment be for this scenario? A male patient, 54 years of age, comes in on May 3, 2014 for a scheduled transurethral resection of the prostate (TURP). The patient had an initial TURP back in August 2012 but is still experiencing...