May 8, 2020 | By Paul Spencer, CPC, COC Time, as it applies to procedures and services, is a vastly misunderstood portion of the Resource Based Relative Value Scale (RBRVS), the methodology used to generate the relative value units (RVUs) that determine the payment for every CPT code. For many years, information on the…
May 1, 2020 | By Stephanie Allard, CPC, CEMA, RHIT Over the years I have found that one of the main risks to an organization are employees who get comfortable in their positions to the point where the explanation for or response to an audit variance is “that is how we have always…
April 24, 2020 | By Stanley Nachimson, Nachimson Advisors After a lengthy period of comments and discussions with industry leaders and vendors, the final Interoperability Rules for EHRs and health plans were released by HHS. These rules contain a myriad of technical and policy requirements for the electronic exchange of standardized data among providers…
April 17, 2020 | By Priscilla J. Alfaro, MD, FAAP, CPC, CPMA, COC, CFE ICD-10 was finally officially implemented on October 1, 2015. One of the intents of moving to ICD-10 was to enable and encourage reporting diagnoses with a higher level of specificity. Many payers expect claims to contain specific codes to support the…
April 10, 2020 | By Jill Young, CPC, CEDC, CIMC The Centers for Disease Control and Prevention (CDC) released its ICD-10 documentation guidelines for COVID-19, using the newly adopted code U07.1. You can find the CDC’s guidance document here https://www.cdc.gov/nchs/data/icd/COVID-19-guidelines-final.pdf. The information shows an effective date range from April 1, 2020 through September 30,…
April 3, 2020 | By Sean Weiss, CHC, CEMA, CMCO, CPMA, CPC-P, CMPE, CPC Happy Friday – we made it through another week of change, after change, after change. There have been a lot of side-stepping and dancing around to get to where we are now. I have told clients for weeks that there…
March 27, 2020 | By Grant Huang, CPC, CPMA The recent coronavirus crisis has brought non-face-to-face services to the forefront of coding and billing conversations. With the entire healthcare industry focused on caring for patients during an unprecedented and fast-moving pandemic, the goal of increasing patient access while reducing the risk of spreading infection…
March 23, 2020 | By Rachel Rose, JD, MBA According to the National Institute for Standards and Technology (“NIST”), biometrics is defined as, “[a]utomated recognition of individuals based on their behavioral and biological characteristics [e.g., fingerprints, facial recognition and retinal scans]. In this document, biometrics may be used to unlock authentication tokens and prevent repudiation…
March 20, 2020 | By Shannon DeConda, CPC, CPC-1, CPMA, CEMC, CMSCS Step 1: Telehealth Consent In order to conduct a patient encounter as a telehealth service, the patient must consent to this modality. The consent should include the patient’s explicit agreement to being treated via telehealth rather than in a face-to-face encounter. Each…
March 13, 2020 | By Jesse Overbay, JD Readers of this newsletter and followers of the incredibly talented individuals on the NAMAS team know that conducting internal monitoring and auditing remains one of the seven fundamental elements of an effective compliance plan.[1] Monitoring and auditing within a medical practice or hospital system encompasses many…