March 29, 2024 | By: Teresa Schrage, RDCS, RVT, CPC, CPMA Reporting an E/M with separately reported services continues to be a topic of discussion amongst coders, auditors, and providers. First, let’s review what a significant, separately reported E/M is and what identifies the service. An E/M is significant and separately identifiable from a procedure/service…
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April 12, 2024 | By: Tammy Welch, CPMA Eye allergy, also called allergic conjunctivitis, is quite common. They occur when the eyes react to something that irritates them (called an allergen). The eyes produce a substance called histamine to fight off the allergen. As a result, the eyelids, conjunctivitis, and eye allergies do not spread…
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April 19, 2024 | By: Beth Schleeper, COC, CPC, CPCO, CDEO, CPB, CPMA, CPPM, CRC, CPC-I, CEMC, CANPC, CEMA, CMCS, CMRS AHHHHHCHHOOO! The sound of Spring and Allergies is in the air. If you are like many of us, you have these pesky critters year-round. So how do we report for the services and supplies?…
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April 26, 2024 | Sean M. Weiss, CHC, CEMA, CMCO, CPMA, CPC-P, CMPE, CPC The perennial inquiry into the scope of services that nurses and ancillary support staff may offer under physician supervision remains a frequent topic of discussion. Furthermore, I frequently encounter situations where the concept of “incident-to” care is central to the controversy.…
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April 5, 2024 | By: Terry A. Fletcher BS, CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, ACS-CA, SCP-CA, QMGC, QMCRC, QMPM (updated 4/6/2024) 2024 brought new HCPCS codes that Medicare, Medicare Advantage and some 3rd-party Commercial plans that they will now pay for. One of those codes is the G0136; that is the Social Determinate…
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Updated 02-09-2024 | By: Terry A. Fletcher BS, CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, ACS-CA, SCP-CA, QMGC, QMCRC, QMPM As we all know the PHE, public health emergency, ended on May 11th, 2023, but the confusion on how to report Telehealth services continues to live on. When Medicare published their Final Rule last November…
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May 3, 2024 | By J. Paul Spencer, CPC, COC Primary care providers are increasingly becoming gatekeepers to mental and behavioral health care. This is due partly to increased awareness in the medical field of the overall health effects brought about by mental illness, as well as the addition of CPT codes for reimbursement that…
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May 10, 2024 | By: LaDonna D. Brown CPC, CPMA, CEMA When I was asked if I would like to be a contributor to NAMAS May articles, my first thought was absolutely. This is particularly timely as May is Mental Health Awareness Month, a crucial period for coders and auditors to reflect on the importance…
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March 22, 2024 | By Carol Ittig, MBA, CMPE Introduction: In the fast-paced world of healthcare billing, clean claims are the key to maximizing revenue and minimizing headaches. A significant contributor to claim denials is inaccurate patient eligibility information. This article explores a multi-step approach to patient eligibility verification, empowering your team to submit clean…
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September 29, 2023 | By Grant Huang, CPMA, CPC If you’ve never heard of principal care management (PCM) or chronic care management (CCM) services before, you’re not alone. Medicare introduced these new benefits for Part B beneficiaries in 2021 and 2022, respectively, but the agency’s own utilization data shows that adoption has been fairly…
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