by Kate Hutchison | Aug 18, 2026 | Auditor Insights
A new Department of Health and Human Services (HHS) Office of Inspector General (OIG) audit puts sacroiliac (SI) joint injections squarely in the Medicare compliance spotlight. Issued on August 3, 2026, the full OIG audit details documentation, billing, and workflow...
by Tamara Jones | Aug 11, 2026 | Auditor Insights
A new billing requirement is now in effect for behavioral health services provided by pre-licensed and unlicensed clinicians under Health First Colorado. What Changed July 1? Effective July 1, 2026, pre-licensed and unlicensed clinicians may not...
by Leah Culley | Jun 12, 2026 | Auditor Insights
Split/shared visits continue to be a frequent source of audit findings—not because the services weren’t appropriately provided, but because the documentation doesn’t clearly identify who performed the substantive portion of the visit. The Documentation...
by Susan Bonham | Jun 1, 2026 | Auditor Insights
Coding assistant-at-surgery services in a teaching hospital can be challenging, particularly when determining whether Medicare will reimburse the assistant. One of the most common misconceptions is assuming that an assistant surgeon is automatically paid whenever they...
by Leah Culley | Jun 1, 2026 | Auditor Insights
Point-of-care (POC) testing is common in today’s clinical setting, but it’s also one of the most frequently misunderstood components of E/M coding. A common misconception is that every POC test performed automatically counts toward the Amount and/or...
by Deanna Upston | May 6, 2026 | Auditor Insights, Uncategorized
Modifier 22 is often used to capture cases that required increased procedural services, but a key question remains: do your claims truly support it—and is it worth the effort? What Payors Expect To justify modifier 22, documentation must go beyond stating that a case...
