April 5, 2024 | By: Terry A. Fletcher BS, CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, ACS-CA, SCP-CA, QMGC, QMCRC, QMPM (updated 4/6/2024) 2024 brought new HCPCS codes that Medicare, Medicare Advantage and some 3rd-party Commercial plans that they will now pay for. One of those codes is the G0136; that is the Social Determinate…
April 26, 2024 | Sean M. Weiss, CHC, CEMA, CMCO, CPMA, CPC-P, CMPE, CPC The perennial inquiry into the scope of services that nurses and ancillary support staff may offer under physician supervision remains a frequent topic of discussion. Furthermore, I frequently encounter situations where the concept of “incident-to” care is central to the controversy.…
March 29, 2024 | By: Teresa Schrage, RDCS, RVT, CPC, CPMA Reporting an E/M with separately reported services continues to be a topic of discussion amongst coders, auditors, and providers. First, let’s review what a significant, separately reported E/M is and what identifies the service. An E/M is significant and separately identifiable from a procedure/service…
March 22, 2024 | By Carol Ittig, MBA, CMPE Introduction: In the fast-paced world of healthcare billing, clean claims are the key to maximizing revenue and minimizing headaches. A significant contributor to claim denials is inaccurate patient eligibility information. This article explores a multi-step approach to patient eligibility verification, empowering your team to submit clean…
September 29, 2023 | By Grant Huang, CPMA, CPC If you’ve never heard of principal care management (PCM) or chronic care management (CCM) services before, you’re not alone. Medicare introduced these new benefits for Part B beneficiaries in 2021 and 2022, respectively, but the agency’s own utilization data shows that adoption has been fairly…
March 15, 2024 | By Sonal Patel, BA, CPMA, CPC, CMC | CEO & Principal Strategist at SP Collaborative, LLC Introduction Did you know that under-documenting poses an audit hazard for any specialty provider? This is not spoken about too loudly by payors since their primary focus is identifying overpayments, rather than underpayments. Nevertheless, I…
March 8, 2024 | By Ashley Morgan, Esq. of Liles Parker PLLC A common issue that arises from a growing practice is how to structure the business to remain compliant while reducing potential liability concerns. Many times, practices grow and continue to operate in the same manner as they did when they only had one…
February 16, 2024 | By Jennifer McNamara, CCS, CPC, CDEO, CPMA, CRC, COSC, CGSC, COPC, AAPC Approved Instructor | CEO, Healthcare Inspired, LLC Beyond Box Checking Compliance with reporting Evaluation and Management (E/M) services often takes center stage and has received much attention in recent years. They are the main revenue stream for Primary Care…
March 1, 2024 | By: Crystal May, CCS, CPC, CDEO, CPMA, CRC, Approved Instructor Breaking Down ICD-10-CM 7th Characters for Traumatic Fracture Care: Coders often get overwhelmed with coding traumatic fractures, typically due to the numerous 7th characters available. But coding them isn’t as scary as it seems once you understand how they break down.…
February 23, 2024 | By Anonymous Source Electrocardiograms (EKG or ECG) and telemetry are indispensable tools in the field of cardiac health. They have revolutionized how healthcare professionals diagnose and monitor various heart conditions, from arrhythmias to heart attacks. EKGs record the heart’s electrical activity, while telemetry involves wireless data transmission from a patient’s heart…