May 12, 2023 | By Scott Kraft, CPMA, CPC The E/M Documentation Guidelines implemented in 2021 essentially place, time and medical decision making on equal footing. When visit time is documented, the service can be coded based on whichever of time and medical decision making is most favorable to the provider. This has led…
May 5, 2023 | By Stacie L. Buck, RHIA, CCS-P, RCC, RCCIR, CIRCC It is no secret that interventional radiology is one of the most difficult specialties for coders and auditors to master. In particular, coding correctly for embolization procedures can be tricky due to the multiple coding considerations involved. This article provides tips…
March 28, 2023 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT With the adaptation of 2021 Guidelines and the reduction in documentation requirements, many coders and auditors had thought the use of copy and paste may begin to phase out. Unfortunately, this has not been the case, primarily because many providers are still…
May 20, 2022 | By Toni Elhoms, CCS, CPC, CPMA, CRC I know I am not the only one who is completely appalled by the recent bombshell story on Cigna’s shady claims adjudication practices. ProPublica recently published a scathing article that pulls back the curtain on “PXDX” – a cost-containment strategy deployed by Cigna…
April 14, 2023 | By David Glaser It’s almost a staple at conferences attended by coders: you should have insurance! And be careful to make sure you aren’t going to jail! But while these scary speeches may be common, that doesn’t make them accurate. The reality is that it is very, very rare…
April 7, 2023 | By Rachel Rose, JD, MBA Overview Whenever I present, which is often, I often receive follow-up questions from participants regarding resources to utilize when creating, reviewing, and/or supplementing a compliance program, including relevant policies and procedures. One resource which should be utilized is the Health Care and Public Health Sector…
March 31, 2023 | By Pam Vanderbilt, CPC, CPMA, CPPM, CPC-I, CEMC, CDEO, CPB, CFPC, CRC, CPEDC, CEMA President, Knowledge Tree Billing, Inc. A lot happens in March! Spring officially begins — bringing with it new growth, Spring Break, and basketball fans across the country get bracket crazy with March Madness. In all the…
March 24, 2023 | By Jennifer McNamara, CCS,CPC,CDEO,CPMA,CRC, COSC,CGSC,COPC, AAPC Approved Instructor | Director of Education and Coding, oncospark When auditing medical charts, there are significant differences between evaluation and management services (E/M) and surgical services. These differences are essential to understand to ensure that the medical documentation is accurate, complete, and compliant with regulatory requirements.…
Just as we have changed professionally post-COVID, our work environments also may have changed or may need to change. In Today’s Take, I’d like to discuss the structural changes that need to take place post-COVID. Recently, Stephanie Allard did an amazing job presenting a NAMAS webinar addressing the organizational structure of your internal audit teams.…
March 17, 2023 | Terry A. Fletcher BS, CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, ACS-CA, SCP-CA, QMGC, QMCRC, QMPM With the end of the PHE comes the planning, due diligence of correct information, and then re-training of physicians and staff to make sure everything is consistent and correct practice wide. Here are a…