One of the amazing benefits of a NAMAS membership is “Ask The Expert”. For this “Take”, I’m going to share one of the questions submitted to us by a NAMAS member, Carol, about emergency room leveling related around chest pain and high complexity. So, Carol writes that the data column for most of their patients…
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July 21, 2023 | By Scott Kraft, CPMA, CPC Whenever I audit charts under the 2021 E/M Documentation Guidelines, which now apply in all places of service, I like to start by reviewing the first and third columns. The first column is Number and Complexity of the Presenting Problem, and the third column is…
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July 14, 2023 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT This week’s tip is a different type, but one that will still be useful. I have been reflecting over the past few weeks- probably more like overthinking a well-lived life. I lost my beautiful mom on June 16 as her heart and…
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July 7, 2023 | By Victoria Moll, CPC, COC, CPMA, CRC, CPFC, CPRC, AAPC Approved Instructor, Fellow CEO, Contempo Coding It’s a frequent grievance heard in the healthcare sphere – patients walk in for their “no-cost” annual exam only to walk out with a bill for a separate office visit due to an existing…
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June 30, 2023 | By Sonal Patel, CPMA, CPC, CMC, ICDCM One of my favorite childhood memories includes learning how to paint. Messy and fun, fingerpainting and potato printing held my attention for years. As I got a little older, I marveled at how I could create masterpieces by using the “paint by numbers”…
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June 23, 2023 | By J. Paul Spencer, CPC, COC We all knew that these days were on the horizon. Now that we find ourselves over a month after the expiration of the Public Health Emergency (PHE), audit activity from commercial and governmental payers, which picked up significantly in 2022, shows no signs of…
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June 16, 2023 | By Rhonda Buckholtz, Owner, Coding and Reimbursement Experts Cataract surgeries are the most commonly performed procedure in ophthalmology, and there are many nuances when auditing that you need to keep in mind. If you stay current on the legal cases that are published, you will see that co-management of cataract…
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June 9, 2023 | By Pam Vanderbilt, CPC, CPMA, CPPM, CPC-I, CEMC, CDEO, CPB, CFPC, CRC, CPEDC, CEMA President, Knowledge Tree Billing, Inc. You may be thinking, “Really, Pam? Are we talking about modifier 25 again?!?” Yes! Considering the recent uproar caused by one payer’s plan to implement a policy requiring prepayment review of…
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A question that I get asked repeatedly, that I haven’t taken the time to address in a long time, came up on a webinar that I was doing for orthopedic executives and coders. What happens when a provider sees a patient and then later finds out that they were a resident of a Skilled Nursing…
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June 2, 2023 | By Grant Huang, CPMA, CPC You’ve got just over a month before July 1, the day that modifier JZ (zero drug wasted) becomes mandatory on all claims for drugs in single-use containers that are used up without wastage. It’s a seemingly simple change that is being backed up by explicit…
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