May 28, 2026 | Forensic AI Alerts
Rising Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) expenditures and utilization continue to increase payment integrity risk across healthcare reimbursement. As CMS expands enforcement efforts, including enrollment moratoria for certain...
Apr 30, 2026 | Forensic AI Alerts
What are skin substitutes? A skin substitute is a product that is engineered from human, animal or synthetic materials and is used to treat chronic non-healing wounds such as diabetic ulcers and venous leg ulcers. Skin substitute codes range from Q4100-Q4353 and new...
Feb 27, 2026 | Forensic AI Alerts
Unsupported laboratory services linked to various referral patterns and inappropriate business relationships remain prevalent schemes, with numerous civil and criminal prosecution cases brought by the U.S. Department of Justice. Some referring providers for...
Feb 2, 2026 | Forensic AI Alerts
The American Medical Association’s (AMA) 2026 Current Procedural Terminology (CPT) code set includes 418 changes, consisting of 288 new codes, 84 deletions, and 46 revisions. Among the most impactful updates are significant expansions to Remote Patient Monitoring...
Jan 9, 2026 | Forensic AI Alerts
When a patient’s medical condition requires emergency transportation or the patient is non-ambulatory, ambulance services are the preferred method to ensure the patient receives the necessary level of care during the trip and arrives at the nearest, appropriate...
Oct 28, 2025 | Forensic AI Alerts
The Add-On Epidemic: Fighting Fraud, Waste, and Abuse Beyond the Pandemic When COVID-19 testing became routine, some laboratories began attaching high-cost “add-on” laboratory tests. While the public health emergency may have ended, the billing patterns it created...
