Industry Notes

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This industry notes article summarizes several timely Medicare and home health topics. It covers CMS guidance expanding the set of tests that may be reported as CLIA-waived, a home health therapy compliance resource created in response to federal scrutiny, and a major fraud takedown announced by federal authorities. The piece is useful for billing staff, compliance teams, home health agencies, and other healthcare professionals tracking regulatory and enforcement developments.

Why This Topic Matters

The article helps readers stay current on changing Medicare-related reporting requirements, compliance resources for therapy services, and enforcement activity that may affect billing oversight and risk management.

Article Sections

  1. CMS CLIA-waived test update

    A Medicare billing update describing changes related to laboratory testing reported under CLIA-waived status. The section references related CMS and MLN Matters guidance and a set of example tests.

  2. Home health therapy compliance resource

    A discussion of a home health industry report developed to address therapy compliance concerns. The section notes the report’s purpose, participating organizations, and the types of clinicians involved.

  3. Medicare Fraud Strike Force enforcement action

    A summary of a large federal fraud enforcement action involving multiple cities and healthcare professionals. The section describes the general types of allegations and the scope of the takedown.

What You Will Learn

  • How the article frames recent Medicare-related laboratory testing updates
  • Why home health therapy compliance has become a focus area
  • What the article says about a major federal fraud enforcement announcement
  • Which organizations and agencies are referenced in the update

Who Should Read This

  • Medical coders
  • Billing staff
  • Compliance officers
  • Home health agencies
  • Healthcare administrators
  • Revenue cycle professionals

Codes Discussed

  • CPT: 87880
  • CPT: 86308
  • CPT: 82274
  • HCPCS Level II: G0328
  • HCPCS Level II: G0434

Modifiers Discussed

  • CPT: QW

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