HIPAA Considerations When Business Associates and Data are International.

  December 9, 2022 | By Rachel Rose, JD, MBA Overview Although it is said that “business is global”, there are some nuances to this blanket statement to consider when creating, receiving, maintaining, or transmitting electronic protected health information or electronic health information (herein the blanket term “PHI” is used) internationally.[i] Before delving into items…

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The Role of the History and Examination in 2023 Evaluation and Management Services

  December 2, 2022 | By Jill Young, CPC, CEDC, CIMC While listening to the virtual AMA CPT/RBRVS Annual Symposium lecture by Gift Tee, BS, MPH, Director of the Division of Practitioner Services in the Hospital and Ambulatory Policy Group (HAPG) of CMS on the Update from Centers for Medicare and Medicaid Services (CMS), I…

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A Long Time Coming: 2023 Changes to Inpatient Prolonged Services

  November 25, 2022 | By Grant Huang, CPMA, CPC It’s been two years since CMS collaborated with the AMA to revamp Evaluation & Management (E&M) coding guidelines, including a rework of prolonged services codes in the office/outpatient setting. This process culminated in a disagreement between the AMA’s CPT manual and CMS’ fee schedule final…

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Determining Risk for Compliance Program

  November 18, 2022 | By Rhonda Buckholtz, Owner, Coding and Reimbursement Experts Determining risk is important for having an effective compliance program. Policies need to be developed to your specific needs. Depending on your specialty, your geographic area, your risk areas, etc. For example, yours might be diagnostic testing, modifiers, emergency evacuations, ASC rules,…

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2023 Revisions to the 2021 E&M Documentation Guidelines

Acute uncomplicated illness or injury requiring hospital inpatient or observation level care As 2021 documentation guidelines are moving into other types and places of service, it’s time to start taking a deep dive! I want to start by looking at some of the implementations that have changed. There were two major new adaptions in the…

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