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…

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,…