March 19, 2021 | By Jeannie Cagle, RN, BSN, CPC, Senior Manager, The Coker Group As is often the case, large organizations have teams of people who have particular expertise to benefit everyone. Health care is no exception. As coders and auditors, it is easy for us to be sequestered behind closed doors with…
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March 5, 2021 | By Stephanie Allard, CPC, CEMA, RHIT When I begin to work with a new client on an auditing project, I like to set up a meeting with them before we begin, to talk through the steps that I take as an auditor and to discuss their reason for the audit…
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December 31, 2019 | By Stephanie Allard, CPC, CEMA, RHIT As of January 1, 2020, CPT made changes to the health and behavior assessment and intervention codes (96150-96155) and therapeutic interventions that focus on cognitive function (97127). If you code and audit services in this category, you must pay close attention to…
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January 8, 2020 | By Shannon DeConda, CPC, CPC-I, CEMC, CMSCS, CPMA It is truly amazing to finally begin to see new reimbursement opportunities for services that providers have given for years without compensation. One such area is in a new code set this year for Behavior Assessment & Intervention. This code…
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January 19, 2020 | By Sean Weiss, CHC, CEMA, CMCO, CPMA, CPC-P, CMPE, CPC Welcome to 2020! It is my hope that all of you had a great holiday season and New Year and are well-rested and ready to take on the challenges of this new year head-on and armed with the necessary…
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January 24, 2020 | By Frank Cohen, Director of Analytics and Busines Intelligence The first thing to note is that I am not an auditor. So, for me to write an article on auditing tips might seem a bit out of place. But this is not an article on auditing compliance but rather…
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March 6, 2020 | By Paul Spencer, CPC, COC Something of a preemptive celebration is currently going on in the world of physician documentation. As we know, beginning in January 2021, CMS will modify documentation guidelines for evaluation & management services to put more of an emphasis on medical decision making, rather than…
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March 13, 2020 | By Jesse Overbay, JD Readers of this newsletter and followers of the incredibly talented individuals on the NAMAS team know that conducting internal monitoring and auditing remains one of the seven fundamental elements of an effective compliance plan.[1] Monitoring and auditing within a medical practice or hospital system encompasses many…
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March 20, 2020 | By Shannon DeConda, CPC, CPC-1, CPMA, CEMC, CMSCS Step 1: Telehealth Consent In order to conduct a patient encounter as a telehealth service, the patient must consent to this modality. The consent should include the patient’s explicit agreement to being treated via telehealth rather than in a face-to-face encounter. Each…
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March 23, 2020 | By Rachel Rose, JD, MBA According to the National Institute for Standards and Technology (“NIST”), biometrics is defined as, “[a]utomated recognition of individuals based on their behavioral and biological characteristics [e.g., fingerprints, facial recognition and retinal scans]. In this document, biometrics may be used to unlock authentication tokens and prevent repudiation…
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