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OIG: CMS should enforce post-op reporting data during global period

09/15/2025

On August 27, the OIG published a report regarding global surgery data. CMS bundles all services associated with a surgical procedure under its global surgery policy, and it collects information on the number of post-operative visits for a typical patient to help set the valuation for these procedures.

RPM, RTM utilization zooms, and so do RTM denial rates

09/15/2025

by: Roy Edroso

In a series of reports, the OIG warns of possible serious misuse of remote physiological monitoring (RPM) codes, for which Medicare utilization has skyrocketed. OIG clarifies that they’re not talking about remote therapeutic monitoring (RTM) codes, possibly because, from rising denial rates, it appears as if the MACs are doing a good job of spotting bad claims themselves.

Laws on mental health and AI spread; watch liability when adding services

09/08/2025

by: Roy Edroso

States are adding legislative restrictions to artificial intelligence (AI) health care chatbots. While the burden of compliance largely falls on companies who develop and market the products, it’s worth keeping some tips in mind when you contract with vendors.

How OCR leadership changes could escalate HIPAA enforcement

09/08/2025

by: Dom Nicastro

The appointment of Paula M. Stannard in early June as director of the Office for Civil Rights (OCR) signals a return to assertive legal interpretation and enforcement of HIPAA, one steeped in institutional history and a broad view of federal oversight, according to compliance experts.

Counter anti-vaccine publicity with facts and respect

09/08/2025

by: Roy Edroso

Question: Normally we have a fall immunization drive with posters and patient reminders. But the subject seems politically fraught these days. Should we just keep silent about it and let our patients make their own decisions without our input?

Solve common errors in skin substitute claims

09/08/2025

by: HCPro staff

One of the most common errors seen in skin substitute claims is the inappropriate application of drug waste modifiers.

As telehealth use slips, some states drop faster than others

09/08/2025

by: Julia Kyles, CPC

For the second year in a row, one-quarter of eligible Medicare patients took advantage of the expanded telehealth benefits, according to the latest telehealth trends and utilization report from CMS.

Patients challenging you with misinformation? Tread lightly.

08/25/2025

by: Roy Edroso

A subject that doesn’t often come up in physician satisfaction studies is the impact of social media on the doctor-patient relationship. But as shown by a recent survey, some physicians are worried about how it’s affecting their patients’ health care choices. Experts offer advice on how to handle difficult situations that may arise from that — and how to protect yourself if you decide to counter misinformation online yourself.

Patients threaten bad review to get favors? Maybe cut a deal.

08/25/2025

by: Roy Edroso

If a patient threatens to place bad reviews unless your physician does them a favor, assess the threat rationally — and, if it seems cost-effective, consider cutting a deal.

Navigate CPT Appendix S: AI taxonomy for medical services, procedures

08/25/2025

by: JoAnn Baker, CCS, CPC, COC CPC-I

With advancements in artificial intelligence (AI) and augmented intelligence enabled health care, the AMA provided guidance outlined in the CPT Manual’s Appendix S taxonomy for describing and classifying various AI applications.

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