A female doctor in a white coat sits at a desk holding a pen while speaking with a female nurse in teal scrubs who is standing beside her with a supportive hand on her shoulder. Both have stethoscopes around their necks and are engaged in a focused conversation in a bright medical office setting.

Roles and Compliant Documentation in Ancillary Staff: A Medical Coding and Compliance Perspective

Article Reference Code: NAMAS.07.18.2025 Roles and Compliant Documentation in Ancillary Staff: A Medical Coding and Compliance Perspective  Written by: Stephanie Allard In the highly regulated world of healthcare, the integrity of clinical documentation is the foundation of everything we review for compliance. We must remember that providers are not the only ones that are responsible…

Auditing Moderate (Conscious) Sedation Services

Article Reference Code: NAMAS.07.11.2025 Understanding Coding, Documentation, and Common Pitfalls in Moderate Sedation Services Written by:  Aimee Wilcox Moderate (conscious) sedation is an important component in enhancing patient comfort and cooperation during various medical and dental procedures. It is a drug-induced state during which patients remain conscious and able to respond to verbal instructions but…

Auditing the AMA’s New Telemedicine Evaluation and Management (E/M) Codes: 98000–98016

Understanding New Audio-Only and Brief Telehealth E/M Codes: Documentation, Compliance, and Medicare Guidelines Written by: Gabriel Aponte Moberg The audio-only codes 98008 through 98015 require more than ten minutes of synchronous, real-time verbal communication. These services may be selected based on either total time or medical decision-making (MDM). Each code corresponds to specific MDM levels and…