Risk Adjustment Opportunities in the World of Simplified Documentation

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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Auditing & the Attorney Client Privilege: Need for audits and incentives to comply/disclose to government

  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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Biometrics – the New Battleground in Privacy and Security

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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Interprofessional Consult Services

  March 27, 2020 | By Grant Huang, CPC, CPMA The recent coronavirus crisis has brought non-face-to-face services to the forefront of coding and billing conversations. With the entire healthcare industry focused on caring for patients during an unprecedented and fast-moving pandemic, the goal of increasing patient access while reducing the risk of spreading infection…

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ICD-10-CM Diagnosis Coding for COVID-19

  April 10, 2020 | By Jill Young, CPC, CEDC, CIMC The Centers for Disease Control and Prevention (CDC) released its ICD-10 documentation guidelines for COVID-19, using the newly adopted code U07.1. You can find the CDC’s guidance document here https://www.cdc.gov/nchs/data/icd/COVID-19-guidelines-final.pdf. The information shows an effective date range from April 1, 2020 through September 30,…

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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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