September 15, 2023 | By: Edward Baker, Of Counsel | Lieff Cabraser Heimann & Bernstein If you lie awake at night worrying about whether your coding, auditing, or compliance practices might be based on misinterpretations of federal law, opening up your healthcare employer—or yourself!—to treble damages and penalties under the False Claims Act (FCA), you may…
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September 17, 2021 | By Doug Graham, Senior Management Consultant and Director of Concierge Medicine Services, DoctorsManagement By law, CMS is required to structure the MIPS program such that 1 out of 2 clinicians will be penalized each year. Non-compliance, submitting inaccurate or incomplete data, or failing to meet the points threshold and category…
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Have you seen the new free NAMAS E&M Mind Map download? The idea behind the Mind Map is that sometimes it’s easier to process and understand things through visual downloads. We envision this as being something that you, as an auditor or coder, may find value in, but also for educating providers, it’s easy to…
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October 27, 2023 | By Rachel Rose, JD, MBA “Do not go gentle into that good night” is a poem by Dylan Thomas. While this poem is often connected with a dying individual, it is equally apropos to procuring technology which includes generative artificial intelligence (“AI”). As set forth in the American National Standard…
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October 20, 2023 | By Jennifer McNamara, CCS, CPC, CDEO, CPMA, CRC, COSC, CGSC, COPC, AAPC Approved Instructor | CEO, Healthcare Inspired, LLC Every year we get updates to the Official Guidelines for Official Guidelines for Coding and Reporting, and this year for reporting year 2024 we received an update regarding Chapter 21 for…
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October 13, 2023 | By J. Paul Spencer, CPC, COC Way back in 1976, as an elementary school kid in the suburbs of Philadelphia, I came across a book in the library called 2010: Living in the Future. In my then-current world of AMC Pacers and seersucker suits, the book promised great things. Apparently,…
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Amy C. Pritchett, CCS, CRC, CPA-RA, CPC, CPMA, CPCO, CDEI, CDEO, CDEC, CANPC, CASCC, CMPM Manager, HCC Coding/Audit & Education Services, Pinnacle Enterprise Risk Consulting Services AAPC Fellow |Approved Instructor |ICD-10-CM/PCS Trainer On March 31, 2023, the Centers for Medicare and Medicaid Services (CMS) released the CY 2024 Medicare Advantage (MA) Capitation Rates along…
DetailsOctober 3, 2023 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT Have you seen the new AMA Smart Brief on Modifier 25 that was released on August 17th? That’s what I want to talk to you about today. I want to break down the information because I specifically noticed there is a stark…
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Let’s have a conversation about the data column on MDM. Specifically, what I’d like to address is imaging services. When a provider performs an x-ray while seeing a patient, and they are not going to bill a professional component of that test, how do we count that service? Is that service something we can count?…
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September 4, 2020 | By Brenda Edwards, CPC, CDEO, CPB, CPC-I, CEMC, CRC, CMRS, CMCS Is anybody not aware of the Evaluation and Management (E/M) changes coming in January 2021? Have you asked your administrator, managers, front office, back office, and providers if they are ready for these major changes? Anybody that touches CPT® 99202-99215…
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