November 3, 2023 | By Sonal Patel, BA, CPMA, CPC, CMC, ICDCM Fresh insights from the American Medical Association (AMA) are always welcome when it comes to medical coding policy. Although they have provided previous guidance on the appropriate use of modifier -25, the AMA’s Smart Brief on August 17, 2023, also provides…
Have you seen the new free NAMAS E&M Mind Map download? The idea behind the Mind Map is that sometimes it’s easier to process and understand things through visual downloads. We envision this as being something that you, as an auditor or coder, may find value in, but also for educating providers, it’s easy to…
October 27, 2023 | By Rachel Rose, JD, MBA “Do not go gentle into that good night” is a poem by Dylan Thomas. While this poem is often connected with a dying individual, it is equally apropos to procuring technology which includes generative artificial intelligence (“AI”). As set forth in the American National Standard…
October 20, 2023 | By Jennifer McNamara, CCS, CPC, CDEO, CPMA, CRC, COSC, CGSC, COPC, AAPC Approved Instructor | CEO, Healthcare Inspired, LLC Every year we get updates to the Official Guidelines for Official Guidelines for Coding and Reporting, and this year for reporting year 2024 we received an update regarding Chapter 21 for…
October 13, 2023 | By J. Paul Spencer, CPC, COC Way back in 1976, as an elementary school kid in the suburbs of Philadelphia, I came across a book in the library called 2010: Living in the Future. In my then-current world of AMC Pacers and seersucker suits, the book promised great things. Apparently,…
Amy C. Pritchett, CCS, CRC, CPA-RA, CPC, CPMA, CPCO, CDEI, CDEO, CDEC, CANPC, CASCC, CMPM Manager, HCC Coding/Audit & Education Services, Pinnacle Enterprise Risk Consulting Services AAPC Fellow |Approved Instructor |ICD-10-CM/PCS Trainer On March 31, 2023, the Centers for Medicare and Medicaid Services (CMS) released the CY 2024 Medicare Advantage (MA) Capitation Rates along…
October 3, 2023 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT Have you seen the new AMA Smart Brief on Modifier 25 that was released on August 17th? That’s what I want to talk to you about today. I want to break down the information because I specifically noticed there is a stark…
Let’s have a conversation about the data column on MDM. Specifically, what I’d like to address is imaging services. When a provider performs an x-ray while seeing a patient, and they are not going to bill a professional component of that test, how do we count that service? Is that service something we can count?…
September 29, 2023 | By Grant Huang, CPMA, CPC If you’ve never heard of principal care management (PCM) or chronic care management (CCM) services before, you’re not alone. Medicare introduced these new benefits for Part B beneficiaries in 2021 and 2022, respectively, but the agency’s own utilization data shows that adoption has been fairly…
September 22, 2023 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT Let’s get uncomfortably honest. With continued reimbursement cuts, like this year’s $9-12k per provider E/M cut, organizations cannot sustain 100% coding validation. Now, let’s get brutally honest. This is compounded by a lack of truly skilled and knowledgeable coders looking to fill the…