Getting Serious About Compliance

  September 10, 2021 | By Jesse Overbay, JD By now, most health systems, practices, and providers should know that the Office of Inspector General (“OIG”) has been stressing the importance of creating and abiding by a compliance plan since the passage of the patient Protection and Affordable Care Act in 2010.  In its own…

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Acute Uncomplicated vs Complicated Illness or Injury

August 27, 2021 | By Jamee Black, CPC, COC, CPMA One of the most difficult determinations of Number and Complexity of Problems Addressed is complicated vs uncomplicated. When selecting Number and Complexity of Problems Addressed, the complication of treatment required should not be considered. The Risk of Complications of Patient Management is where the treatment…

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A New Element of MDM: Social Determinants of Health

  March 26, 2021 | By Jamee Black, CPC, COC, CPMA The American Medical Association (AMA) recently released changes to the current Evaluation and Management (E/M) documentation guidelines for the Office and Other Outpatient Visit code range (99202–99215). The new guidelines focus on medical decision making (MDM), and are intended to more closely reflect the…

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As Pandemic Eases, OIG Ramps Up Audits

  August 13, 2021 | By Grant Huang, CPC, CPMA With Americans having widespread access to effective vaccines, the COVID-19 pandemic is finally fading into the background for most practices, but the issue of compliance is once again rearing its multi-faceted head. This time, after billions of dollars in federal spending as part of pandemic…

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