Look out for imaging TC/global denials same day as admission

Article Overview

This article discusses a Medicare claims-edit change that can affect diagnostic imaging billing when a patient’s admission date overlaps with the date of service. It is relevant to physician practices, especially orthopedic and cardiology groups, because it explains the broad category of denials, recoupment activity, and remittance messages that may appear on claims and why practices should review explanation-of-benefits activity closely. The piece also notes the CMS and OIG context behind the edits and mentions that a fix was being pursued.