Inside Angle

From 3M Health Information Systems

Tag: OIG

Eyes on Eylea and Lucentis

August 9th, 2019 / By Divya Verma, RHIA

Recently, I came across an OIG announcement “Review of Medicare Part B Claims for Intravitreal Injections of Eylea and Lucentis” released in June 2019. Upon reading this announcement, I pulled […]

The importance of medical necessity compliance: Recent actions by the U.S. Attorney’s Office and the OIG

July 16th, 2018 / By Barbara Aubry, RN

I’ve been talking about this for years. I still see folks who don’t think compliance with medical necessity polices is critical. Believe me, I understand human nature; noncompliance can be […]

Caution ahead: Coding of right heart caths (RHC) with a biopsy

May 2nd, 2018 / By Rebecca Caux-Harry

At AAPC’s annual Healthcon conference in Orlando, Florida, Dr. David Zielske (also known as Dr. Z) had a session on Interventional Radiology, Cardiology and Vascular Surgery coding. As you can […]

Fallout from the opioid crisis or improper coding?

March 7th, 2018 / By Barbara Aubry, RN

I review OIG updates as they are released and I saw something last week that unfortunately, I did not find surprising. Per the OIG report: “Payments made to providers for […]

Lest we forget: Focus still on medical necessity

December 6th, 2017 / By Barbara Aubry, RN

Can you believe 2017 is coming to a close? Did this year fly by for everyone, or is it just me? Some pretty interesting ideas were put forth in 2017, […]

OIG: The cost of noncompliance? $66+ million to be recovered from hospitals

October 30th, 2017 / By Barbara Aubry, RN

In September 2017, Office of Inspector General (OIG) released a report titled “Medicare Inappropriately Paid Acute-Care Hospitals for Outpatient Services They Provided to Beneficiaries Who Were Inpatients of Other Facilities.” […]

Article: Coders Beware: CMS Surgical Audits Began July 1

With Barbara Aubry, RN

3M’s Barbara Aubry urges coders to provide adequate clinical documentation to support CPT code 99024.

The population health elephant

April 5th, 2017 / By Barbara Aubry, RN

Last month, I blogged about long held tenants of medical necessity and how those standards impact today’s creative thinking on actions to improve health outcomes. I received interesting questions from […]

HIMagine that: Guideline 19 revisited

February 6th, 2017 / By Donna Smith, RHIA, Sue Belley, RHIA

Donna: Hey Sue, have you read the WEDI document on the 2016 ICD-10-CM Clinical Indicators? This is another opinion on Guideline 19, which was published in the 2017 “ICD-10-CM Official […]

Medical device replacements and the OIG

July 13th, 2016 / By Barbara Aubry, RN

Seems little in health care is straightforward.  An area that I’ve often found confusing has become even more complex: Accurately reporting medical devices. To meet CMS regulations, not only do […]

The OIG turns their attention to Provider-Based Clinics

June 27th, 2016 / By Rebecca Caux-Harry

I have always wondered why the reimbursement for services provided at a Provider-Based Clinic (PBC) was higher (often more than 50 percent higher) than the same services provided at a […]

Millions Claimed by Lost Physicians and Coders

June 10th, 2015 / By Barbara Aubry, RN

There was only one time in my life that I literally did not know where I was. I had just moved to Alexandria, Virginia and took a wrong turn off […]