When Denials Attack: Outpatient E/M Services Denied with 2020 Rationale

  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…

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A New Element of MDM: Social Determinants of Health

  March 26, 2021 | By Jamee Black, CPC, COC, CPMA The American Medical Association (AMA) recently released changes to the current Evaluation and Management (E/M) documentation guidelines for the Office and Other Outpatient Visit code range (99202–99215). The new guidelines focus on medical decision making (MDM), and are intended to more closely reflect the…

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Critical Care Billing: It’s the Little Things

  February 19, 2021 | By David Carpenter   Critical care billing is relatively simple. Documentation requires three items – The patient is critically ill. What the provider is doing to treat or prevent organ system failure or compromise. How much time the provider spent providing critical care. While critical care billing is relatively simple,…

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