tci Medicare Compliance & Reimbursement - 2013 Issue 9
Industry Notes
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Article Overview
This industry update covers several Medicare and CMS developments relevant to coders, billers, compliance staff, and post-acute care providers. It discusses the ICD-10 transition timing and claims handling implications, an OIG budget request focused on oversight and improper payment prevention, and CMS guidance related to the home health improvement standard and related coverage review activities. The article is useful for readers tracking federal administrative changes that may affect claims processing, compliance, and coverage policies.
Why This Topic Matters
The topics in this update affect how claims are submitted, how compliance programs monitor risk, and how Medicare coverage issues are interpreted across multiple care settings. It is especially relevant for organizations preparing for diagnosis coding changes and for providers watching CMS enforcement and policy clarification efforts.
Article Sections
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Dx Coding Rules Change: Don’t Get Caught Asleep at the Wheel
Covers the ICD-10 implementation timing discussed in CMS and MLN Matters guidance, along with the article’s summary of claims processing changes tied to the transition. It also notes the correction referenced by a Medicare administrative contractor.
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OIG Asks Government for An Additional $82 Million for CMS Oversight
Summarizes the Office of Inspector General budget request and the broader focus on oversight, fraud prevention, and improper payment reduction in Medicare and Medicaid.
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Home Health Improvement Standard One Step Closer To Getting The Boot
Reviews CMS guidance on the home health improvement standard, related coverage clarification, and planned follow-up materials and claim review activities.
What You Will Learn
- How CMS described the timing and administrative impact of the ICD-10 transition
- What the OIG budget request signals about Medicare and Medicaid oversight priorities
- How CMS is framing guidance related to the home health improvement standard
- What kinds of follow-up educational and review activities CMS said it would undertake
Who Should Read This
- Medical coders
- Billing staff
- Compliance officers
- Health information management professionals
- Home health providers
- Post-acute care providers
- Medicare claims administrators
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