I’ve worked as a HIM coder for almost 20 years. Our industry has talked about the conversion of ICD-9 to ICD-10 for my whole career. I am very practical and really didn’t see the Feds spending the gobs of money required … Continue reading →
“Scope Creep” in Appeals is Dead CMS has instructed MACs and QICs to limit their review to the reason(s) the claim or line item at issue was initially denied. For redeterminations and reconsiderations of claims denied following a complex prepayment review, a complex post-payment review, or an automated post-payment review by a contractor, Limiting the scope of review on redeterminations and reconsiderations of certain claims. MLN Matters Number SE1521.