December 1, 2023 | By Natasha Timberlake, BSHCM, CRCR, CPC, CPB, COC, CRC, CPPM, CPMA, CHONC, AAPC Approved Instructor Reviewing the rules and guidelines regarding chemotherapy and therapeutic infusions and injections can be intimidating and confusing. Here are some helpful tips to help it become easier to understand. The first step is to review the…
August 4, 2023 | By Bryan Meek, Esq., Brennan, Manna, and Diamond OVERVIEW: As telehealth has become more prominent across the country, providers have had the opportunity to practice across state lines more easily. However, most states require that providers be licensed in their state to provide care to residents in their state. Thus,…
June 12, 2020 | By By Bryan Meek, Esq., Brennan, Manna, and Diamond As the COVID-19 pandemic continues to wreak havoc globally, many industries have been forced to adapt to unprecedented challenges while remaining cognizant of everchanging guidance from public health officials and government agencies. Notably, the healthcare industry has been confronted with countless practical…
November 17, 2023 | By Amanda Waesch This past September 2023, the Office of Inspector General for the U.S. Department of Health and Human Services (OIG) issued Advisory Opinion 23-06 (AO).1 The Opinion involved a proposed arrangement between an independent pathology laboratory and third-party physician laboratories for the purchase of the technical component of…
November 10, 2023 | By Toni Elhoms, CCS, CPC, CPMA, CRC On countless occasions, I have heard physicians and healthcare providers balk at the notion of learning how to level their E/M services based on medical-decision-making (MDM), and some will even go as far as to say things like “I don’t have time…
November 3, 2023 | By Sonal Patel, BA, CPMA, CPC, CMC, ICDCM Fresh insights from the American Medical Association (AMA) are always welcome when it comes to medical coding policy. Although they have provided previous guidance on the appropriate use of modifier -25, the AMA’s Smart Brief on August 17, 2023, also provides…
June 3, 2022 | By Pam Brooks, MHA, COC, PCS, CPC, Fellow Federal oversight makes healthcare one of the most highly regulated industries in the United States. From a compliance perspective, that oversight poses significant risk for organizations who are unaware of the federal requirements, as well as providing opportunities for compliance professionals to…
June 17, 2022 | By Sean Weiss, CHC, CEMA, CMCO, CPMA, CPC-P, CMPE, CPC I am constantly being asked what can be done when government and commercial payors are slow-walking claims for payment. The simple answer is to know your state and federal law. First, let’s tackle the federal law which is 42 CFR…
September 15, 2023 | By: Edward Baker, Of Counsel | Lieff Cabraser Heimann & Bernstein If you lie awake at night worrying about whether your coding, auditing, or compliance practices might be based on misinterpretations of federal law, opening up your healthcare employer—or yourself!—to treble damages and penalties under the False Claims Act (FCA), you may…
September 17, 2021 | By Doug Graham, Senior Management Consultant and Director of Concierge Medicine Services, DoctorsManagement By law, CMS is required to structure the MIPS program such that 1 out of 2 clinicians will be penalized each year. Non-compliance, submitting inaccurate or incomplete data, or failing to meet the points threshold and category…