The CERT Program

The CERT Program

Jul 19, 2023 | Article

What It Is and What a Practice Needs to Know The Comprehensive Error Rate Testing (CERT) program is a crucial component of the Medicare program that helps ensure the government is paying only for the services and care that beneficiaries actually receive. The program...
Comparative Billing Reports (CBRs)

Comparative Billing Reports (CBRs)

May 10, 2023 | Article

What Are They, and What Do We Do With Them? CMS (Centers for Medicare and Medicaid) is always implementing various programs and initiatives aimed at reducing fraud, waste, and abuse. One such initiative is Comparative Billing Reports (CBRs). In this article, an...

Chronicity of the Condition

Feb 3, 2023 | Coding Quandry

Question: One point of clarification I’ve wondered about. What defines the chronicity of the condition? Is it if it’s lasted more than one year already for the patient or is it if we know that it’s going to last more than a year even if it’s...

Shave Biopsy

Apr 7, 2022 | Coding Quandry

Question: When I am performing a shave biopsy, I append diagnosis code D48.5 to the service.  My coder is telling me that it is incorrect, and I should use D49.2 instead.  Who is correct?  Answer: The coder is correct on this one.  D48.5 is Neoplasm of Uncertain...
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