January 21, 2022 | By Sean Weiss, CHC, CEMA, CMCO, CPMA, CPC-P, CMPE, CPC While I am sure you have heard it several dozen times by now, I want to welcome you to 2022 because that is where the pleasantries end. 2022 will see Medical Necessity put front & center not only in audits…
January 14, 2022 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT In 2022, when we sit down to configure an audit plan, we often consider whether we will perform an audit retrospectively or prospectively and whether the sample will include evaluation and management (E&M) services, procedures or some combination of them both. What we…
January 7, 2022 | By Toni Elhoms, CCS, CPC, CPMA, CRC It’s our favorite time of the year again – coding and regulatory compliance update season! As I’m sure many of my compliance colleagues can relate, this is the time of the year when we get inundated with “Can I pick your brain” requests…
December 24, 2021 | By Grant Huang, CPMA, CPC The 2021 E/M guidelines’ more permissive rules for time-based coding is a potential watershed moment for physicians who want to spend less of their time documenting E/M notes. But if we interpret these changes to mean that the longstanding concept of “medical necessity” can be…
December 17, 2021 | By Stephanie Moore, CPC, CPMA Many facilities will require a preoperative history and physical within 30 days of a procedure. Does this requirement from the facility support the medical necessity of an E/M visit? The answer is maybe. Medicare transmittal 1719 states, ”For purposes of billing under the Physician Fee…