Betsy Nicoletti, MS, a nationally recognized coding expert, will take your coding questions via email and provide guidance on how to code properly to maximize reimbursement. Have a question about ...

A handful of payers were flagged throughout 2021 by HHS’ Office of the Inspector General for coding or reimbursement errors. 1. Humana: HHS found April 20 that Humana received $197.7 million in ...

This year ushered in many changes affecting reimbursement for healthcare providers, but few are as important as the new Physician Fee Schedule from the Centers for Medicare & Medicaid Services (CMS) ...

Instruction can be found in Section II of the 2021 ICD-10-CM Official Guidelines for Coding and Reporting for "Selection of Principal Diagnosis." Q: When two conditions are both present on admission, ...

Differential coding by Medicare Advantage plans appeared to have pushed their risk scores higher than traditional Medicare's scores. Those greater risk scores led to $33 billion in extra revenue for ...