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…
Here’s Your Sign… Shannon O. DeConda, CPC, CPMA, CEMA, CPA-EDU August 30, 2024 I recently visited a new provider’s office and noticed two prominent signs posted everywhere—one about a $100 no-show fee and another offering B-12 shots for cash. Surprisingly, the compliance issue isn’t with the no-show fee but with the B-12 cash service. Let’s…
The Well Woman Exam Crystal Tompkins CDEO, CPMA, CPC, CRC, COBGC, and Educator and Auditor September 13, 2024 I will never forget the wonder of being asked to write an article for NAMAS. The nerd in me was ecstatic, and the auditor/coder in me was completely in shock. After that feeling subsided, reality quickly set…
Safeguarding Medical Necessity in Non-face-to-face Exchanges Anna McGregor CLP, CPC, CPCO, CPMA, CPA-RA, CEMC, CEMA September 6, 2024 Has there been a moment when auditing an encounter when one wondered if this service was necessary because a reasonable indication for medical services was not identified? Should medical necessity be identified as the appropriateness of a non-face-to-face…
Navigating Prescription Drug Medical Weight Loss Stephanie Allard, CPC, CEMA, CPA-RA, RHIT August 23, 2024 This year, a recurring issue is continuing to pop up in the audit reviews that I am completing for clients. The issue is related to medical weight loss and what I think is a complete misunderstanding in the industry regarding…