Healthicity Blog

Modifier 59 is here, there, and everywhere!

It’s one of the most frequently used and misused modifiers in medical coding and billing, and it indicates that a procedure or service was distinct or independent from other services performed on the same day by the same provider.

A fundamental tenet of healthcare billing compliance is that services must be medically necessary.

In June 2023, the U.S. Department of Health and Human Services Office of Inspector General (OIG) added many more items to their work plan. Let’s take a look at some that may be particularly important for compliance professionals in the health care industry.

As compliance professionals, staying on top of recent enforcement actions by the U.S. Department of Justice (DOJ) can be a challenge – but we’re here to help. Understanding recent enforcement actions is a crucial way to guide compliance programs, risk assessments, education efforts, and auditing...

Written policies and procedures are often listed as the first element of an effective compliance program. Though all the elements really work together, and no singular element is necessarily more important than another, it does make sense to list written policies and procedures as the first element.

The U.S. Health and Human Services Office of Inspector General (OIG) recently signaled an even stronger focus on nursing homes. The OIG plans to more closely scrutinize nursing home compliance in their work plans, audits, and oversight.

Can you believe we’re heading into the second half of 2023? This year is moving faster than you can say “HIPAA.”

Compliance professionals in the nursing home sector are well aware of the many ways government agencies survey, audit, and enforce regulatory compliance. Nursing homes have seen significant enforcement over the last few years, and the U.S. Department of Health and Human Services Office of Inspector...