Understanding Independent Interpretation in E/M Coding: Three Essential Requirements

Compliance, Evaluation & Management: 2021 & Beyond, News & Events, Payer Rules, Practice Management, Procedural Coding & Auditing, Revenue Cycle ManagementLeave a comment

Understanding Independent Interpretation in E/M Coding: Three Essential Requirements Shannon O. DeConda, CPC, CPMA, CEMA, CPA-EDU October 4, 2024 In the realm of Evaluation and Management (E/M) coding, independent interpretation is an often misunderstood component of the Medical Decision Making (MDM) table. Proper documentation of independent interpretation is required to impact the MDM and, consequently,…

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Insurance Discrimination – Against the Provider

Compliance, Legislative Action, News & Events, Payer Rules, Practice Management

Insurance Discrimination – Against the Provider Author: Jeana M. Singleton, Esq.  When the concept of “insurance discrimination” rears its ugly head, we often think of it in the context of when an insurance company treats some people differently than others based on protected classes, such as race, national origin, sex, or religion.  Sometimes, this type…

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Auditing the Infusion Center

E/M Coding & Auditing, Evaluation & Management: 2021 & Beyond, News & Events, Procedural Coding & Auditing

  November 15, 2024 | By Scott Kraft, CPMA, CPC When I audit services performed in an infusion center, I’m addressing two key questions. First, were all of the patient’s infusion, injection, and/or hydration services documented appropriately for what is being billed? Second, if evaluation and management services were performed, were they medically necessary and…

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Oncology Coding Tip: Mastering the Complexities of Radiation and Medical Oncology Billing

CPT, News & Events, Procedural Coding & Auditing

  November 22, 2024 | By Jordan Johnson, MSHA Coding for oncology services is an intricate task, requiring attention to detail, a deep understanding of clinical workflows, and the ability to navigate multiple systems and payer requirements. In radiation oncology, services often span multiple months, with a patient’s treatment involving 30-50 Current Procedural Terminology (CPT)…

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Here’s Your Sign…

Compliance, Evaluation & Management: 2021 & Beyond, News & Events, Payer Rules, Practice Management, Procedural Coding & Auditing, Revenue Cycle ManagementLeave a comment

Here’s Your Sign… Shannon O. DeConda, CPC, CPMA, CEMA, CPA-EDU August 30, 2024 I recently visited a new provider’s office and noticed two prominent signs posted everywhere—one about a $100 no-show fee and another offering B-12 shots for cash. Surprisingly, the compliance issue isn’t with the no-show fee but with the B-12 cash service. Let’s…

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