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Investigation included 55 million records from 2019. Adjustment codes are sometimes too vague to clearly identify whether a Medicare Advantage Organization (MAO) denied payment for a service, the Office of Inspector General (OIG) concluded in a February 2023 Issue Brief. Without specifics about the services for which the MAO is denying payment, the OIG cannot […]
The post Ambiguity Surrounding MAO Claim Denials Hampers Fraud Detection appeared first on AAPC Knowledge Center.
Medicare now covers screening for pulmonary malignancy with LDCT starting at age 50. After reconsideration of eligibility criteria, the Centers for Medicare & Medicaid Services (CMS) announced on Feb. 10 a national coverage determination (NCD) that expands coverage for lung cancer screening with low dose computed tomography (LDCT) for Medicare patients. This move is in […]
The post LDCT Coverage Expanded to Enable Earlier Detection of Lung Cancer appeared first on AAPC Knowledge Center.
The latest changes to the CPT® code set will help clinicians distinguish seasonal infections from COVID-19 in their reporting. Three new CPT® codes have been created, Oct. 6, that will allow clinicians to distinguish the tests for influenza A, influenza B, and respiratory syncytial virus (RSV) that include SARS-CoV-2 from those that don’t. The new […]
The post 3 New Codes for Infectious-Agent Detection appeared first on AAPC Knowledge Center.