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Beware of signs of lawsuit-prone patients, and keep documentation professional

09/15/2025

Train everyone in your practice to take a preventive approach to litigious patients, meaning patients who threaten to file complaints or sue for any reason or no reason at all. Everyone in the practice, from the scheduler to the surgeon, needs to recognize the signs and know how to communicate their concerns about a patient so they don’t make a bad situation worse. The approach also works for patients who are merely difficult and reasonable patients who are considering a lawsuit.

Get ready for 4% cut: Budget shutdown not likely to stop Medicare sequester

09/15/2025

by: Roy Edroso

There’s an opportunity for Congress to take advantage of the shutdown threat to head off the extra 2% sequestration cut providers face in 2026, but experts advise against getting your hopes up.

Capture CPT, diagnosis coding for accurate pelvic floor therapy billing

09/15/2025

by: Beth Morgan, CPC, MCS-P

When therapy is recommended for a patient, your mind may turn to physical, occupational and speech therapy. However, there is a new type gaining momentum: pelvic floor therapy. This therapy helps individuals to relax and coordinate their pelvic muscles, and understanding the coding terminology and guidelines specific to pelvic rehabilitation is essential for accurate documentation and billing.

After spike in payments, OIG seeks closer watch on remote monitoring

09/15/2025

by: Richard Scott

Payments for remote physiologic monitoring (RPM) services have skyrocketed under Medicare, surpassing $535 million in 2024. That’s up from just $15 million five years earlier. As services spike, the HHS Office of Inspector General (OIG) is sending out a warning: we’re keeping an eye on you.

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

09/15/2025

by: HCPro staff

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.

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