April 9, 2021 | By Amanda Waesch In December 2016, Congress passed the 21st Century Cures Act (often simply called the “Cures Act”). Woven within the Cures Act is Section 4004 titled “Information Blocking.”[1] The purpose of this section is to prohibit any action or practice that interferes with or prevents access to electronic…
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April 2, 2021 | By J. Paul Spencer, CPC, COC We now collectively find ourselves one calendar quarter into the new frontier of 2021 outpatient E/M services. Since January 1, I have fielded many questions from my professional contacts regarding how best to look at the newly-engineered medical decision making (MDM) component. As might…
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March 26, 2021 | By Grant Huang, CPC, CPMA If you thought some of the language in the 2021 E/M guidelines was confusing, you’re not the only one: The AMA has gotten enough questions about its new guidelines to issue a six-page document packed with clarifications and corrections. The document also includes an additional three pages…
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March 19, 2021 | By Jeannie Cagle, RN, BSN, CPC, Senior Manager, The Coker Group As is often the case, large organizations have teams of people who have particular expertise to benefit everyone. Health care is no exception. As coders and auditors, it is easy for us to be sequestered behind closed doors with…
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March 12, 2021 | Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content, innoviHealth Because deaths due to drug overdose is a nationwide epidemic, federal, state, and private organizations created substance use disorder (SUD) programs to treat patients who abuse alcohol or other illicit substances, or who have a history of prolonged…
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March 5, 2021 | By Stephanie Allard, CPC, CEMA, RHIT When I begin to work with a new client on an auditing project, I like to set up a meeting with them before we begin, to talk through the steps that I take as an auditor and to discuss their reason for the audit…
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February 19, 2021 | By David Carpenter Critical care billing is relatively simple. Documentation requires three items – The patient is critically ill. What the provider is doing to treat or prevent organ system failure or compromise. How much time the provider spent providing critical care. While critical care billing is relatively simple,…
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December 31, 2019 | By Stephanie Allard, CPC, CEMA, RHIT As of January 1, 2020, CPT made changes to the health and behavior assessment and intervention codes (96150-96155) and therapeutic interventions that focus on cognitive function (97127). If you code and audit services in this category, you must pay close attention to…
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January 8, 2020 | By Shannon DeConda, CPC, CPC-I, CEMC, CMSCS, CPMA It is truly amazing to finally begin to see new reimbursement opportunities for services that providers have given for years without compensation. One such area is in a new code set this year for Behavior Assessment & Intervention. This code…
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January 10, 2020 | By David Glaser Skepticism is a vital trait in the coding and billing process. Constant questioning is necessary because when you receive guidance from consultants and contractors it may be both clear and categorical, but it’s possible that upon objective review, you will realize it is also cockamamie. For…
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