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…
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
Have you given much thought to an encounter that you might review that actually has CPT or ICD-9 codes documented or included right in the EMR-produced note? (Yes, I do start off many conversations just that way. To be in my head… it’s a scary thing!) So, here’s my question to you: What happens when…
Details
September 30, 2022 | By Christine Hall, Senior Consultant, CHC, CPC, CPB, CPMA, CRC, CEMC, CPC-I Certified Instructor Coordination of benefits can be described as when two or more insurance plans work together to determine the order of coverage liability. This coordination between plans exists to avoid duplicate payment, which could result in…
Details
September 23, 2022 | By Sonal Patel, CPMA, CPC, CMC, ICDCM Can I be honest here? I am thrilled that I am finished with the 1995 and 1997 (“95 and 97”) evaluation and management (“E/M”) guidelines for office and outpatient visits. Okay, okay, obviously I am not serious, but I am happy seeing that…
Details
September 16, 2022 | By Sean Weiss, CHC, CEMA, CMCO, CPMA, CPC-P, CMPE, CPC Audits are nothing new but the requirements tied to them are in a lot of cases. For years I have talked about and encouraged clients to create Corrective Action Plans (CAPS) when they uncover something that requires adjustments and possibly…
Details
September 9, 2022 | By Stacie L. Buck, RHIA, CCS-P, RCC, RCCIR, CIRCC Each day thousands of patients are undergoing one or more therapeutic interventions, the most common ones being angioplasty, stent and atherectomy of the lower extremity arteries to treat various forms of peripheral vascular disease. This article will highlight the most common…
Details
September 2, 2022 | By Bryan Meek, Esq., Brennan, Manna, and Diamond Patients missing their healthcare appointments without adequate notice can cost practices a lot of money, as well as deprive patients of necessary care. While one solution to mitigate this damage is to charge patients for missed appointments, policies should be written…
Details
August 26, 2022 | By Beth Schleeper, COC, CPC, CPCO, CDEO, CPB, CPMA, CPPM, CRC, CPC-I, CEMC, CEMA Most of us are very aware of the risks inappropriate bundling modifier usage can cause, but when is the last time we thought about how other modifiers may put us at risk? For example, what about our surgical modifiers…
Details
August 19, 2022 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT Training techniques used from the 2021 Documentation Guidelines training and implementation may be helpful with training for these updates as well, even though these updates relate to different types and places of service. However, a lesson learned from 2021 was that education,…
Details