July 30, 2021 | By Scott Kraft, Auditing Specialist, DoctorsManagement While payers have increasingly turned away from covering consultation services, this type of billing is not extinct yet. Consultations can be done in the office and inpatient setting, and just as a refresher, are billed when a provider is requesting the professional opinion of…
July 23, 2021 | By Rachel Rose, JD, MBA In June 2021, the U.S. Department of Health and Human Services Office of the Inspector General (HHS-OIG) issued Issue Brief, OEI-01-20-00220 (hereinafter “Issue Brief”), which highlighted the results of its review of cybersecurity for networked medical devices in hospitals. The impetus behind the review was…
July 16, 2021 | By David Glaser On May 3rd CMS pulled the shared visit language from the Manuals. The government has increasingly recognized that only statutes and regulations can limit Medicare coverage, so when something in the Manuals is not contained in either a federal law or a federal regulation, it is not binding.…
July 9, 2021 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT After 6 months of speaking to the 2021 AMA guidelines, many of you may be tired of talking about the new documentation guidelines. But the other half of us are frustrated at still seeing documentation come through that represents the mandated…
July 2, 2021 | By Pam Brooks, MHA, COC, CPC As an auditor, you might find that the “meat and potatoes” of the audit is the most interesting part. Then you finish and it is time to pull together your findings into an executive summary. The best and most effective executive summary design is…
June 25, 2021 | By Stephanie Allard, CPC, CEMA, RHIT When I ask practices if they have been through an external audit recently, they typically will state “no” or let me know if recent requests for a larger number encounter notes have been received. Through these conversations, I realize that they are not noticing…
June 18, 2021 | By Bryan Meek, Esq., Brennan, Manna, and Diamond The pandemic has undisputedly changed the way in which Americans live their daily lives, including how they receive medical care. Patients have increasingly been receiving care via telemedicine, virtual check-ins, or e-visits in order to avoid physically going to their appointments and…
June 11, 2021 | Edward Townley CPC, CEMC, CUC, ROCC, Founder, Cogent9 Consulting Challenges for patients in cancer care include many devastating factors, including loss of a job or changes in job status, such as switching to part-time work or taking extended leave. For those who have a job to return to, there are…
June 4, 2021 | By Cheryl A. Cyrus, RHIT, CPMA, CDEO, CRC, Comforcehealth, Quality Assurance Auditor As of January 1, 2021, we have been given new Evaluation and Management Guidelines for Outpatient Office and Ambulatory services that encompass specific areas of risk defined in the SDOH (Social Determinants of Health). As a Profee auditor,…
May 28, 2021 | Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content, innoviHealth Prolonged services codes were created to capture reimbursement for time spent with a patient that goes beyond the typical time associated with the primary service. We’re all aware of those patients that, unexpectedly, require so much prolonged provider…