January 14, 2022 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT In 2022, when we sit down to configure an audit plan, we often consider whether we will perform an audit retrospectively or prospectively and whether the sample will include evaluation and management (E&M) services, procedures or some combination of them both. What we…
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January 7, 2022 | By Toni Elhoms, CCS, CPC, CPMA, CRC It’s our favorite time of the year again – coding and regulatory compliance update season! As I’m sure many of my compliance colleagues can relate, this is the time of the year when we get inundated with “Can I pick your brain” requests…
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December 24, 2021 | By Grant Huang, CPMA, CPC The 2021 E/M guidelines’ more permissive rules for time-based coding is a potential watershed moment for physicians who want to spend less of their time documenting E/M notes. But if we interpret these changes to mean that the longstanding concept of “medical necessity” can be…
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December 17, 2021 | By Stephanie Moore, CPC, CPMA Many facilities will require a preoperative history and physical within 30 days of a procedure. Does this requirement from the facility support the medical necessity of an E/M visit? The answer is maybe. Medicare transmittal 1719 states, ”For purposes of billing under the Physician Fee…
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December 10, 2021 | by Kelley Chappell Larkins, CPMA, CPC Are you ever tempted to just sweep those small claim denials under the rug? Do you sometimes wonder if it is worth the time and effort to figure out why a code, which will end up yielding $30, is being denied? Does it feel…
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December 3, 2020 | By Holly Cassano, CPC, CRC There are not many positives that are generally born out of a Pandemic, but for the COVID 19 Pandemic, there have been a few and one of them is the creation of the HRSA Uninsured Portal. I call it a provider “Godsend” as it has…
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November 26, 2021 | By Toni Elhoms, CCS, CPC, CPMA, CRC As I am sure many of my colleagues can relate, I have frequently heard statements like, “All my E/M services are coded based on time because it’s just easier” or “I add total time to all my notes just to cover my bases”.…
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November 17, 2021 | By Scott Kraft, CPMA, CPC A physician practice revenue cycle analysis is really driven by that old saying “Follow the Money.” Along the journey, however, we learn a lot more about payment buckets and accounts receivable, as important as those factors are for practice operations. Very rarely do I perform…
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October 29, 2021 | Edward Townley CPC, CEMC, CUC, ROCC, Founder, Cogent9 Consulting This is the time of year that we receive our new coding manuals. First the ICD-10, which becomes effective October 1 and CPT and HCPCS manuals which come nearer to the end of the calendar year, and effective January 1. For…
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October 22, 2021 | By Scott Kraft, Auditing Specialist, DoctorsManagement Like many of my auditing colleagues, I entered 2021 with a solid understanding of the rules of the 2021 E/M Documentation Guidelines, but looked forward to seeing how they were applied in practice by the rendering provider. Now that we’ve entered October, one area…
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