As we begin the new year and our focused training for the 2023 E&M changes and revisions, I’d like to encourage everyone to refocus their efforts on column three of medical decision-making. The header of column three is very specific, and it’s wordy. I think sometimes we fail to notice that because we’re stuck in…
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November 18, 2022 | By Rhonda Buckholtz, Owner, Coding and Reimbursement Experts Determining risk is important for having an effective compliance program. Policies need to be developed to your specific needs. Depending on your specialty, your geographic area, your risk areas, etc. For example, yours might be diagnostic testing, modifiers, emergency evacuations, ASC rules,…
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I can’t remember if I’ve recently covered this topic, so one of us (or maybe both of us) may have Deja vu today. We’re still getting inundated with questions about Problems Addressed regardless of the place or type of service, so whether I’ve already covered this topic or not, it bears addressing it again. Cheryl,…
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Terry A. Fletcher BS, CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, ACS-CA, SCP-CA, QMGC, QMCRC, QMPM Incident to a physician’s professional services means that the services or supplies are furnished as an integral, although incidental, part of the physician’s personal professional services in the course of diagnosis or treatment of an injury or illness.…
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June 10, 2022 | By Scott Kraft, CPMA, CPC I regularly see E11.22 coded, followed by the stage of chronic kidney disease when a patient has diabetes with chronic kidney disease. I’m not sure if I’m unlucky, but I rarely see the same correct diagnosis coding when it comes to hypertension and chronic kidney…
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Acute uncomplicated illness or injury requiring hospital inpatient or observation level care As 2021 documentation guidelines are moving into other types and places of service, it’s time to start taking a deep dive! I want to start by looking at some of the implementations that have changed. There were two major new adaptions in the…
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October 21, 2022 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT Whether reviewing common questions received through the NAMAS Ask the Auditor form, questions received during our webinars, BootCamps, workshops, or during provider training and audit feedback sessions, two topics seem to always be on replay. These topics are the proper use of…
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The 2021 documentation guidelines for INPATIENT services will be effective on January 1st, 2023, and we hope you’re ready! What I want to address in this post relates to the middle column; Data. This has proven to be a problem in the office setting, which was our first rollout, and I can tell you, I…
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October 14, 2022 | By Sean Weiss, CHC, CEMA, CMCO, CPMA, CPC-P, CMPE, CPC Why is it that payors often, can’t or won’t comply with their own reimbursement rules or guidelines for processing/adjudicating claims? Some (who are contracted to The Centers for Medicare and Medicaid Services (CMS)) may view this blog in a negative…
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Have you given much thought to an encounter that you might review that actually has CPT or ICD-9 codes documented or included right in the EMR-produced note? (Yes, I do start off many conversations just that way. To be in my head… it’s a scary thing!) So, here’s my question to you: What happens when…
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