Healthicity Blog

You sit down and feel your jaw tighten, your pulse quicken, and your shoulders cramp up like you’ve slept on a boulder all night.

On August 3, 2018, the Department of Justice announced a settlement with the physician practice Northwest ENT Associates, in Georgia.

The OIG has added new work plan items in July 2018. I’ve detailed the items I find the most interesting below.

For fun, let’s take a short quiz. Would you say that the following scenarios would be coded as a new or established patient?

EXAMPLES OF MODIFIER 59 ERRORS

Your organization is losing money. The OIG HHS reported that nearly 42% of Medicare claims for E/M services are incorrectly coded resulting in $6.7 billion in overpayments.

Modifier 59 is shockingly confusing for coders, auditors and physicians alike. It’s frequently misused, for example, it’s often added as prevention or recoupment of an insurance denial as a way to get additional procedures paid.

1. Former Orange County lab Owner Sentenced to 8 Years for Healthcare Fraud –

Healthcare fraud and abuse are hot topics right now, it’s more important than ever to get on top of new codes and keep your practice audit-ready. Knowledge is power. This handy list will help you update CPT codes and stay current. Educate providers and staff using the following auditing resources.