RMC’s Blog

Medicare/Medicaid Underpayments a 75 Billion $ Reality per AHA Report

Across healthcare we focus on patient care and outcomes which is primary and foremost. In addition, we also focus on revenue and the revenue cycle. This will mean overpayments, which are compliance and financial risks and underpayments which are also both a compliance...

COVID-19 Vaccination and CPT Coding Resources

We are all hearing and seeing news and information daily about the efforts to vaccinate the United States population against COVID-19 and progress is being made. With this medical effort there is a wealth of published guidance and facts that have been developed by the...

JAMA Released Study on DRG Trends

In a recent Journal of the American Medical Association (JAMA) a study on the highest reimbursed DRG (Diagnostic Related Group) trends from 2012 to 2016 was released. Medicare DRGs or Medicare Severity DRG (MS-DRGs) payment system includes the capture ICD-10-CM codes...

USING CERT (Comprehensive Error Rate Testing) to Improve Coding Quality

The Centers for Medicare and Medicaid Services (CMS) has several programs they sponsor and/or support that target “improper payments”. One of those programs is Comprehensive Error Rate Testing or CERT. The purpose of CERT is to measure the Medicare Fee-For-Service...

AMA Releases Additional CPT for Johnson & Johnson COVID Vaccine

The American Medical Association (AMA) released on January 19th, 2021 new CPT codes for the COVID vaccine administration and the vaccine by Johnson and Johnson, which is still pending approval by the FDA.  This COVID-19 vaccine was under development by Janssen...

The OIG Workplan and Building Your Coding Compliance Plan/Program

Each year the Office of Inspector General (OIG) publishes their healthcare workplan and this is an “opportunity” for us in review and learn from their areas of focus. The workplan can be viewed at: Work Plan | Office of Inspector General | U.S. Department of Health...