May 27, 2022 | By Sonal Patel, CPMA, CPC, CMC, ICDCM I have been privileged to make my entrance into the world of healthcare and medical coding, specifically after my first career as an art historian dissolved way back in 2008 due to the recession. Mind you, I have taken all my research skills,…
Have you ever had one of those questions that you think you have the answer to, but the more you read it, the more you’re swayed the other way — and then you read it again and you have an even different answer? Well, one of our NAMAS members (and a friend of mine) emailed…
May 20, 2022 | By Toni Elhoms, CCS, CPC, CPMA, CRC Over the past year and a half, I have seen a significant increase in the volume of Unified Program Integrity Contractor (UPIC) investigations taking place in private physician practices. UPICs work on behalf of CMS to perform program integrity functions like detecting fraud,…
I would like to make things right the first time so often, that they have errors and I need to make corrections -and the same is true for providers. In this post, I would like to approach the topic of addendums. The thing about addendums is… there are no clear-cut rules – except how to…
May 13, 2021 | By Rhonda Buckholtz, Owner, Coding and Reimbursement Experts For years we have talked about the culture in healthcare, especially for compliance purposes but for many practices that culture takes a back seat despite continued guidance. Culture is one of the most important features of a medical practice and for compliance…
May 6, 2022 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT A great deal of time was spent this year with new coding updates focusing on critical care split shared updates, but not much time was given to all of the other red-lined updates in the critical care section of the CMS Claims…
You know, those conversations you have between another coder and auditor or better yet, those difficult conversations with a physician about the mechanics of the code vs. the intent of the code? That’s what I want to discuss today. Sometimes this gets lost and it gets the better of us as a coder and/or auditor.…