Industry Notes

Why This Topic Matters

The updates affect claim submission, edit response, and compliance planning across multiple Medicare billing scenarios. Readers need to know which CMS changes are going live and what operational areas may be impacted.

Article Sections

1. ICD-10 Testing Week Announced by CMS

   An announcement about a CMS testing period for sample claims and related implementation timing. The section explains the broad purpose of the testing window and how CMS planned to communicate results afterward.

2. Prominent Cardiologist Faces Over 6 Years in Prison

   A summary of a federal fraud case involving a physician, patient testing, and restitution. The section highlights compliance and enforcement issues in a cardiology-related matter.

3. CMS Sets Jan. 6 as PECOS Ordering/Referring Edit Implementation Date

   A discussion of CMS’s timeline for ordering and referring provider edits and the affected Medicare claim types. The section covers the broader implementation history and operational impact for providers.

4. Medicare Cracks Down On Inpatient Billing For Hospital Patients

   An overview of a new Medicare edit involving inpatient hospital claims and hospice-related billing. The section discusses the agency guidance, contractor involvement, and the implementation timing described in the article.