MACs Revise LCDs Due to ICD-10 Errors Reported After Transition Date
The October 1, 2015, ICD-10 mandated code change caused some issues for 8 of the 12 Medicare Jurisdictions that impact at least 32 states. Some of the Medicare Administrative Contractors (MACs) relied on the General Equivalence Mappings (GEMs) to map ICD-9 to ICD-10 codes, which was insufficient for the Local Coverage Determinations (LCDs). Most of the GEM mappings provide unspecified codes and where ICD-9 LCDs relied on exact codes the GEM mappings are unspecified. The announcement by the Cent ...
Context to Attend ICAHN 2015 CAH Conference in Springfield, IL
Context4 Healthcare, Inc.is set to attend the 2015 CAH Conference, presented by the Illinois Critical Access Hospital Network (ICAHN), being held November 11-12, 2015 at the Crowne Plaza Hotel in Springfield, IL. According to ICAHN's conference website, this year's "theme, 'Strengthening Our CAHs and Their Communities', centers around the importance of critical access and small and rural hospitals and their vital role in attaining and improving population health."
Outsourced Coding Vendors Face ICD-10 Challenges Related to Transition
The October 1, 2015 implementation date for ICD-10 has finally come and gone. While many industry experts had predicted complete chaos, shut-downs and major loss of productivity, as we enter the last week of October, only some of those predictions have come to fruition. It has been extremely quiet on both the provider and payer ends in the month of October. Some have even suggested that all these predictions of doom have come to resemble the Y2K nightmare that never materialized. Or it could be ...
Payers Should Be Alert to Fraudulent & Unnecessary Cardiac Procedures
Payers need to be ever vigilant in watching out for evolving fraud schemes. Case in point is a recent healthcare fraud investigation where a cardiologist was convicted of performing unnecessary cardiac procedures and causing unnecessary coronary artery bypass surgeries, which resulted in Medicare and other insurers overpaying $7.2 million over a six-year period. 1 This scheme was particularly dangerous because it not only cost taxpayers a large sum of money, but the health and lives of this doc ...
Context Goes to Washington as Exhibitor at 35th Annual SIIA Conference
Conference attendees will have the chance to learn about a new product this year - just recently, Context introduced a new Inpatient UCR module as part of its DecisionPoint™ Health Payment System. With the increasingly high cost of inpatient services, many valued UCR customers have been looking for a way to benchmark inpatient facility claims. As the trusted source for UCR fee data (including Medical, HCPCS, Anesthesia, Dental and Outpatient), Context has developed an independent source for inpatient charges for more than 740 Diagnosis-Related Groups (DRGs).