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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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…
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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…
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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…
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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…
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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…
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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…
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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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April 15, 2022 | Edward Townley CPC, CEMC, CUC, ROCC, Founder, Cogent9 Consulting The action cycle for process improvement may be defined by the Plan-Do-Study-Act (PDSA model) (i.e., the Deming cycle or Shewhart cycle). Lean/Six Sigma process improvement processes use another acronym, DMAIC (Define, Measure, Analyze, Improve and Control). All of these processes are…
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September 15, 2023 | By: Edward Baker, Of Counsel | Lieff Cabraser Heimann & Bernstein If you lie awake at night worrying about whether your coding, auditing, or compliance practices might be based on misinterpretations of federal law, opening up your healthcare employer—or yourself!—to treble damages and penalties under the False Claims Act (FCA), you may…
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