Be Specific

  April 17, 2020 | By Priscilla J. Alfaro, MD, FAAP, CPC, CPMA, COC, CFE ICD-10 was finally officially implemented on October 1, 2015. One of the intents of moving to ICD-10 was to enable and encourage reporting diagnoses with a higher level of specificity. Many payers expect claims to contain specific codes to support the…

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Focus Providers on Clinically Relevant History and Exam, and Concise Medical Decision Making

  October 16, 2020 | By Scott Kraft, CPMA, CPC It’s fair to say the 2021 changes to the E/M documentation guidelines ease the documentation burden on the rendering provider for certain aspects of the note. These welcome changes give more heft to the clinical relevance of the patient’s case and the provider’s treatment, rather…

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Finally: CMS releases 2021 final rule; no major surprises seen

  December 15, 2020 | By By Grant Huang, CPC, CPMA At long last, CMS has published its Medicare Physician Fee Schedule (PFS) final rule, and while some of the provisions will be widely felt across many specialties, there are no major or unexpected deviations from the proposed rule. The agency typically releases the PFS…

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What You Need to Know About Prolonged Services in 2021

  December 25, 2020 | By By Grant Huang, CPC, CPMA The New Year is nearly upon us and with it, implementation of the much-talked-about 2021 E/M guidelines for office/outpatient codes 99202-99215. These guidelines include completely revamping how time works for selecting code levels, which in turn has resulted in brand new rules for prolonged…

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Interoperability Rules – New Requirements, New Challenges, New Opportunities for Practices

  April 24, 2020 | By Stanley Nachimson, Nachimson Advisors After a lengthy period of comments and discussions with industry leaders and vendors, the final Interoperability Rules for EHRs and health plans were released by HHS. These rules contain a myriad of technical and policy requirements for the electronic exchange of standardized data among providers…

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