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…
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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…
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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…
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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…
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March 6, 2020 | By Paul Spencer, CPC, COC Something of a preemptive celebration is currently going on in the world of physician documentation. As we know, beginning in January 2021, CMS will modify documentation guidelines for evaluation & management services to put more of an emphasis on medical decision making, rather than…
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February 28, 2020 | By Daniel F. Shay, Esq. Facing the mounting pressure of demographics, the Medicare system looks to slow the outflow of money however it can. One of the chief targets of these efforts is the process by which providers obtain Medicare billing privileges (“enrollment”). Without being enrolled in Medicare, a provider…
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February 21, 2020 | By Pam Vanderbilt, CPC, CPMA, CPPM, CPC-I, CEMC, CEMA, CEMA-O In the first three articles of this series, we explored how the 2021 E&M changes to office visits will affect each element of medical decision making (MDM): diagnoses, data, and the table of risk. In this article, we…
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February 14, 2020 | By Pam Vanderbilt, CPC, CPMA, CPPM, CPC-I, CEMC, CEMA, CEMA-O Next year will see the implementation of significant changes to E&M guidelines, reducing the emphasis on the history and exam components while highlighting medical decision making (M.D.M.). In our last audit tip on the E&M changes, we discussed…
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February 7, 2020 | By Pam Vanderbilt, CPC, CPMA, CPPM, CPC-I, CEMC, CEMA, CEMA-O Previously we explored the 2021 changes that effect how diagnoses will be scored. Today we will dive into the changes to the data element of MDM. We know the year 2021 will bring significant changes to how we…
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January 31, 2020 | By Pam Vanderbilt, CPC, CPMA, CPPM, CPC-I, CEMC, CEMA, CEMA-O The year 2021 will bring significant changes to how we determine the level of evaluation and management services in the outpatient setting. We will no longer score history and exam elements, instead focusing on medical decision making or…
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