January 26, 2024 | By: Karlene Dittrich, CBCS, CPC, CPMA, CECCS | Certified ERISA/PPACA Claims Handling Compliance & Appeal Specialist The most common question I am asked in my seminars sharing relevant laws that support claims handling compliance requirements is: “But what about my contract?” Insurance companies write payer contracts in a way that leaves…
January 5, 2024 | By Victoria Moll, CPC, COC, CPMA, CRC, CPFC, CPRC, AAPC Approved Instructor, Fellow CEO, Contempo Coding The strategic use of Modifier 25, particularly when dealing with same-day procedures within global periods, is essential. Throughout my career, I’ve seen multiple colleagues working on claim edits and would cheerfully apply whatever modifier the…
December 29, 2023 | By Laidy Diana Martinez CPC, CPB, CPMA, CGSC, CGIC, CASCC January 2024 Marks the Arrival of G2211: A Three-Year Wait Ends but raises questions of simplicity versus complexity. Though G2211 isn’t a new concept, it has been on hold due to congressional decisions for the past three years. Finally, in January…
December 15, 2023 | By Stephanie Allard, CPC, CEMA, RHIT One area that keeps coming up in my conversations and education sessions is the definition and understanding, or misunderstanding, of the concept of a “problem addressed” during an encounter and how that is applied to E/M services. As treating practitioners document and as we…
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…