May 6, 2022 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT A great deal of time was spent this year with new coding updates focusing on critical care split shared updates, but not much time was given to all of the other red-lined updates in the critical care section of the CMS Claims…
Most of you are familiar with the medical necessity of the E&M encounter prior to 2021 documentation guidelines. But how does that equate in 2021? Today, we’re going to talk about how to understand medical necessity and 2021 documentation guidelines in the auditing of your encounters. Let’s take a look at the medical decision making…
In Today’s Take, let’s discuss the difference between preventive care. You might be thinking this is “101”. But it really isn’t. Oftentimes, when conducting chart audits, we not only we see issues with a lack of documentation criteria, especially with Medicare preventive services, but we also see confusion regarding the lack of interpretation about what…
April 4, 2022 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT Today, I want to bring you a little educational tidbit on E&M documentation improvement and how to audit those challenging sections of E&M. We’re going to take a look at the third column of our MDM table, the Risk of Complications for…
January 14, 2022 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT In 2022, when we sit down to configure an audit plan, we often consider whether we will perform an audit retrospectively or prospectively and whether the sample will include evaluation and management (E&M) services, procedures or some combination of them both. What we…
August 31, 2021 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT Had you asked me 18 years ago when I first started out as a consultant if I would ever be a public speaker on national speaking circuits, my resounding answer would have been “Haha, no way!”. Today, I am bestowed the honor…
September 9, 2021 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT Never in our lifetime have we encountered a more controversial subject than the daily buzz we hear from co-workers, news networks, social media, and the like related to COVID-19. While most of us are not sitting in a front-line environment (anymore), we…
September 28, 2021 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT The mechanics of auditing can, of course, be acquired through a training course; but then when you find yourself in certain audit roles, you may recognize the lack of experience within skills briefly mentioned during that training. So, how do you work…
October 5, 2021 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT As an auditor, we must expand our skill sets to include a myriad of specialties in which we have expertise. Over the years, I have learned my strengths and certainly learned my weak areas to stay away from. When I trained as…
October 12, 2021 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT 2021 AMA guidance indicates that a general systemic symptom such as fever should not be considered a systemic system, but not all fevers fall in this category. The question typically posed is: what is the “magic” range that identifies it as no…