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NAMAS MEDICAL AUDITING AND COMPLIANCE

Chutes and Ladders E/M Style

2023 AMA Updates, CPT, E/M Coding & AuditingBy NAMASOctober 27, 2022

  October 28, 2022 | By Brenda Edwards, CPC, CDEO, CPB, CPC-I, CEMC, CRC, CMRS, CMCS We are all excited about the upcoming 2023 E/M changes, aren’t we? Well, I can say, as a coder and auditor, I am! I’ve been in this E/M world for about 35 years. Things were easy prior to 1995,…

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Modifier 25 nd Prescription Drug Management

CPT, E/M Coding & AuditingBy NAMASOctober 21, 2022

  October 21, 2022 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT Whether reviewing common questions received through the NAMAS Ask the Auditor form, questions received during our webinars, BootCamps, workshops, or during provider training and audit feedback sessions, two topics seem to always be on replay. These topics are the proper use of…

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2021 E&M: Order and Review for INPATIENT

2023 AMA Updates, E/M Coding & Auditing, Evaluation & Management: 2021 & Beyond, Today's TakeBy NAMASOctober 17, 2022

The 2021 documentation guidelines for INPATIENT services will be effective on January 1st, 2023, and we hope you’re ready! What I want to address in this post relates to the middle column; Data. This has proven to be a problem in the office setting, which was our first rollout, and I can tell you, I…

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Medicare MACs, SMRC, UPIC/ZPIC, and RACs: Why Can’t You Just Comply?

Compliance, Legislative Action, Payer RulesBy NAMASOctober 13, 2022

  October 14, 2022 | By Sean Weiss, CHC, CEMA, CMCO, CPMA, CPC-P, CMPE, CPC Why is it that payors often, can’t or won’t comply with their own reimbursement rules or guidelines for processing/adjudicating claims? Some (who are contracted to The Centers for Medicare and Medicaid Services (CMS)) may view this blog in a negative…

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Let’s Talk About Weed (As in the Doctor…)

2023 AMA Updates, Evaluation & Management: 2021 & BeyondBy NAMASOctober 6, 2022

  October 7, 2022 | By J. Paul Spencer, CPC, COC Early September marked my 33rd year on the administrative side of healthcare. This followed my 56th birthday in April when I officially entered the realm of “pushing 60”. Once you get to be my age, the reaction to my opinion falls into one of…

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Recent Posts
  • Auditing the AMA’s New Telemedicine Evaluation and Management (E/M) Codes: 98000–98016
  • Billing Battles: What to Do When Billing Instructions Don’t Add Up
  • Ancillary Staff vs. Reimbursable Providers: Navigating CMS and Commercial Payor Rules
  • Why Medical Claims Auditors Should Embrace Autonomy for Non-Physician Qualified Providers
  • CCM Under the Microscope: Are Your Providers Documentation-Ready?
  • Before You Bill Incident To—Is the Treatment Plan Really There?
  • Prescription Drug Management Requires More Than a Medication List
  • Non-Medically Necessary vs. Statutorily Excluded Services: Understanding the Differences
  • Prevention of Patient Complaints and Payer Denials: Covered vs Non-Covered Preventive Services
  • Law vs. Health Law Fundamentals
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