CCM Under the Microscope: Are Your Providers Documentation-Ready? Written by: Christine Hall, CHC, CPC , CDEO, CPB, CPMA, CRC, CEMC, CPC-I Chronic Care Management (CCM) services are getting extra attention from Medicare Administrative Contractors (MACs) as part of their Target, Probe, and Educate (TPE) program. They are closely reviewing CCM claims for possible misuse, which…
Before You Bill Incident To—Is the Treatment Plan Really There? Scott Kraft, CPC, CPMA, CEMC, CPA-RA Whenever you perform an audit under Medicare’s Incident to billing rules, you’re really auditing two different things. First, did the visit note support the code assigned and whether it included any documented changes to the patient’s treatment plan. Second,…
Prescription Drug Management Requires More Than a Medication List Written by: Jill Young What documentation is required to show a provider is performing prescription drug management? It has been a question since the changes to the Office or Other Outpatient Services codes was announced by the American Medical Association (AMA) in 2021. The table Elements of Medical Decision…
Nursing Visits in the Office: Navigating Risks and Staying Compliant Written by: Sonda Kunzi Let’s talk about nursing visits. If you have worked in a medical office, you’ve likely heard this term used to describe brief patient encounters with a medical assistant, nurse, or other clinical staff. Things like blood pressure checks, vaccine administration, suture…
November 15, 2024 | By Scott Kraft, CPMA, CPC When I audit services performed in an infusion center, I’m addressing two key questions. First, were all of the patient’s infusion, injection, and/or hydration services documented appropriately for what is being billed? Second, if evaluation and management services were performed, were they medically necessary and…