November 1, 2023 | By Shannon O. DeConda We conducted a comprehensive survey to gain a better understanding of the ongoing debate in the industry about whether the E/M level of services is increasing or decreasing with the latest guidelines implemented in 2021. While we acknowledge that the survey isn’t scientifically conclusive, we urge organizations…
Details
November 3, 2023 | By Sonal Patel, BA, CPMA, CPC, CMC, ICDCM Fresh insights from the American Medical Association (AMA) are always welcome when it comes to medical coding policy. Although they have provided previous guidance on the appropriate use of modifier -25, the AMA’s Smart Brief on August 17, 2023, also provides…
Details
June 3, 2022 | By Pam Brooks, MHA, COC, PCS, CPC, Fellow Federal oversight makes healthcare one of the most highly regulated industries in the United States. From a compliance perspective, that oversight poses significant risk for organizations who are unaware of the federal requirements, as well as providing opportunities for compliance professionals to…
Details
April 2, 2021 | By J. Paul Spencer, CPC, COC We now collectively find ourselves one calendar quarter into the new frontier of 2021 outpatient E/M services. Since January 1, I have fielded many questions from my professional contacts regarding how best to look at the newly-engineered medical decision making (MDM) component. As might…
Details
December 25, 2020 | By By Grant Huang, CPC, CPMA The New Year is nearly upon us and with it, implementation of the much-talked-about 2021 E/M guidelines for office/outpatient codes 99202-99215. These guidelines include completely revamping how time works for selecting code levels, which in turn has resulted in brand new rules for prolonged…
Details
June 17, 2022 | By Sean Weiss, CHC, CEMA, CMCO, CPMA, CPC-P, CMPE, CPC I am constantly being asked what can be done when government and commercial payors are slow-walking claims for payment. The simple answer is to know your state and federal law. First, let’s tackle the federal law which is 42 CFR…
Details
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…
Details
July 28, 2023 | By Jill Young, CPC, CEDC, CIMC I have been a consultant for over 20 years and have worked in the medical field for over 40 years. When I first was in a position that required me to research the rules and policies of both documentation and compliance issues, there was…
Details
October 30, 2020 | By Edward Townley, Founder, Cogent9 Consulting We use relative value units (RVUs) in many aspects of our practices. Some physician compensation arrangements are based on RVUs; other practices use them for staffing models and productivity measurements. Where did RVUs come from and how have they evolved over time? Beginning in…
Details
June 11, 2021 | Edward Townley CPC, CEMC, CUC, ROCC, Founder, Cogent9 Consulting Challenges for patients in cancer care include many devastating factors, including loss of a job or changes in job status, such as switching to part-time work or taking extended leave. For those who have a job to return to, there are…
Details