Attestation Statements – Becoming the Expert

July 19, 2024    Attestation Statements – Becoming the Expert By: Aimee Wilcox, CPMA, CCS-P Medical students become the proud owners of MDs once they have completed medical school; however, to become fully licensed practicing physicians, they must complete additional training. They are required to participate in a three to seven-year residency and fellowship program…

Auditing Complex Surgeries

July 12, 2024    Auditing Complex Surgeries By: Jennifer McNamara, CPC,CCS,CRC,CPMA,CDEO,COSC,CGSC,COPC,CPC-I Medical Auditors are important members of the revenue cycle. They are responsible for monitoring coding and billing compliance and helping to reduce financial risk in healthcare organizations. Seasoned auditors will review highly complex services, such as surgeries performed on the spine. These surgeries require…

Auditing the Global Package

July 5, 2024    By: Mary A Curry, BS, CPC, CPMA Auditing the Global Package When auditing provider services, what is the best method to approach the concept of a global package? Some rental companies provide a renter with all-inclusive pricing for an apartment. The payment arrangement covers heating, electricity, water, and garbage for the…

G2211 Documentation & Sample Policy

Let’s Chat: Today’s Take with Shannon DeConda Topic: G2211 Documentation   It’s no secret that navigating G2211 can be challenging, especially when left without proper guidance. Unfortunately, the lack of clear direction can lead to a never-ending stream of questions and confusion. Today’s Take will provide useful information on the documentation best practices for G2211.…

If It Isn’t Documented, Did It Really Happen?

June 7, 2024   |   By: Bridget Smudrick, BS, MLS(ASCP)  |  Director of CLIA Compliance Where CLIA compliance is concerned, documentation is key. CLIA stands for the Clinical Laboratory Improvement Amendment. This set of federal regulations established in 1988 governs how patient testing is performed in the clinical laboratory setting. These regulations ensure the accuracy of…

Navigating E/M Reporting: Time-Based Billing and Separately Reported Services

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…

Supervision of Ancillary Staff

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.…