Despite naming compliance plans as a top priority, 39 percent of compliance professionals from payors and providers said they were not confident or moderately confident in their ability to demonstrate compliance effectiveness and ability to measure the quality of outcomes,…

In 2008 Medicare erroneously allowed $38 million in claims for interpretation and reports of imaging in outpatient emergency departments, according to a report by the HHS Office of Inspector General.

Karen Bowden, senior vice president of consulting services at Craneware InSight, points to five coding errors or other actions that are most likely to draw RAC attention in the hospital setting.

The American Hospital Association has extended the deadline for hospitals to submit data to its RACTrac survey to April 22, according to an AHA news release.

Lucien Newman III, MD, the founder of ComplyMD, a documentation and coding software solution, listed nine common targets for recovery audit contractors involving surgeons in 2010 in a report in General Surgery News.   

Many healthcare professionals, including medical coders and IT personnel who must upgrade systems to accommodate HIPAA 5010 and ICD-10, would be relieved to see the ICD-10 deadline adjusted, according to a column by Tom Sullivan in ICD-10Watch.

At the American Health Lawyers Association's Institute on Medicare and Medicaid Payment Issues conference, CMS said recovery audit contractors will be encouraged to extrapolate overpayments, according to a Lexology report.

CPT copyright 2010 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.This article first appeared in RACmonitor.

The following Q&A comes from the Centers for Medicare & Medicaid Services website.

In a survey of payors’ claims denials in six states, 39-59 percent of the denials were reversed on appeal, according to a report by the Government Accountability Office. In comparison, the GAO noted that a similar study by an insurance…