Modifier 25: The Drama Never Ends Article Reference Code: NAMAS.05.08.2026 Written by: Angela Clements, CPC, CPMA, CPC-M, CEMC, CGSC, COSC, CCS, AAPC Approved Instructor Modifier 25 is used when documentation supports a “significant, separately identifiable evaluation and management (E/M) service by the same physician or other qualified health care professional on the same day of a…
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Beyond the Grid: Are We Misusing the MDM Table? Article Reference Code: NAMAS.05.01.2026 Written by: Beth Schleeper, COC, CPC, CPCO, CDEO, CPB, CPMA, CPPM, CRC, CPC-I, CEMC, CANPC, CEMA, CMCS, CMRS Medical Decision Making (MDM) was supposed to make E/M leveling easier. Right? Cleaner. Easier. More consistent. Instead, it’s turned into the coding world’s version of…
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I Code It One Way. My Peer Codes It Another. Now What? Article Reference Code: NAMAS.04.24.2026 Written by: Cristin Robinson CPC, CPMA, CCC, CRC, CEMC In today’s healthcare environment, coding is no longer a one‑size‑fits‑all process. Two experienced professionals can review the same medical record and arrive at different coding conclusions—both believing they are correct. With…
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Risky Language: Facet Joint Injection Denials Article Reference Code: NAMAS.04.17.2026 Written by: Robin Sewell CCS, CDIP, CPC, CIC, CCDS I recently reviewed a handful of RAC denials for Medical Necessity of facet joint procedures. Interestingly, the denials mainly focused on one single bullet in the Local Coverage Determination (LCD) Facet Joint Interventions for Pain Management. Namely,…
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The Phrase That Pays: Problem Addressed vs. Problem Listed Article Reference Code: NAMAS.04.10.2026 Written by: Keisha Wilson, CHC, CCS, CPC, CPCO, CPMA, CRC, CPB, AAPC Approved Instructor A Compliance, Coding, and Documentation Perspective For decades, the 1995 and 1997 Evaluation and Management (E/M) Documentation Guidelines trained us to audit based on “quantity”, counting body systems, history…
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