August 21, 2020 | By Jesse Overbay, JD On March 13, 2020, the President of the United States issued an emergency declaration under the Stafford Act to declare a national health emergency, setting in motion a chain of events for the Centers for Medicare and Medicaid Services (“CMS”) and our entire healthcare system that…
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August 28, 2020 | By David Glaser, JD For the compliance-oriented, there is something rewarding about developing policies. It feels like an accomplishment, demonstrable proof of a desire to do the right thing. But speaking as a lawyer, I am convinced that most policies hurt, rather than help, the organization that adopts them. There…
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September 4, 2020 | By Brenda Edwards, CPC, CDEO, CPB, CPC-I, CEMC, CRC, CMRS, CMCS Is anybody not aware of the Evaluation and Management (E/M) changes coming in January 2021? Have you asked your administrator, managers, front office, back office, and providers if they are ready for these major changes? Anybody that touches CPT® 99202-99215…
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September 11, 2020 | By Shannon DeConda, CPC, CPC-1, CPMA, CEMC, CMSCS Living in the “Florida’s Space Coast” we are quite attuned to hearing launch references- and we can certainly relate as we wind down to the 3-2-1 months before the new AMA E&M Guidelines are effective. Kennedy Space Center lists valuable tips for…
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September 25, 2020 | By Grant Huang, CPC, CPMA With two key components of E/M level selection – the history and physical exam – being eliminated as factors for choosing a code level, medical decision making (MDM) will take center stage in 2021. As we begin the final quarter of 2020, coders and auditors…
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October 2, 2020 | By Nicholas Goodwin, Esq. “How did that meeting go with the bank?” John asked, stopping by Dan’s door on his way to his office down the hall. “What meeting?”, Dan responded. Confused, John said “The meeting about the line of credit. You sent me an email about it this morning…
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October 9, 2020 | Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content, innoviHealth If you are an active coder or auditor, you are likely keenly aware of the abundant changes to healthcare laws, regulations, policies, and guidelines surrounding HIPAA, coding, reimbursement, and especially to the integration and rapid expansion of telemedicine…
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October 30, 2020 | By Edward Townley, Founder, Cogent9 Consulting We use relative value units (RVUs) in many aspects of our practices. Some physician compensation arrangements are based on RVUs; other practices use them for staffing models and productivity measurements. Where did RVUs come from and how have they evolved over time? Beginning in…
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November 13, 2020 | By Bryan Meek, Esq., Brennan, Manna, and Diamond As the COVID-19 pandemic continues to wreak havoc globally, routine COVID-19 testing of employees, patients, and the general population have become more common. However, issues regarding coverage for this testing are starting to emerge. In recent weeks, major payers and insurers have…
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November 27, 2020 | By Grant Huang, CPC, CPMA Auditing evaluation and management (E/M) services furnished by resident physicians under the Medicare Primary Exception (PCE) already required a firm grasp of attestation and coding rules – but now COVID-19 throws another wrench into the works. In this audit tip, we will review the rules…
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