Ensuring Compliance with Medicare’s Pain Management G Code Written by: Shannon O. DeConda, CPC, CPMA, CEMC, CEMA, CPA-EDU, CRTT Medicare has been actively enhancing care management services to better support patients with chronic conditions. According to the U.S. Pain Foundation, over 50 million people in the United States are affected by chronic pain, so the…
December 13, 2024 | By Rhonda Granja, B.S., CMA, CPC, RMC, CMC, CMOM, CMIS As we navigate this complex world of coding, every year we prepare for changes, updates, new codes as well as deletion of codes. For 2025, there are 420 overall updates that are in the CPT 2025 code set. Those include…
December 06, 2024 | By Pam Warren, MHA, COC, CPC, Fellow It is very important to healthcare providers and leaders that the work auditors perform, the results auditors report and the recommendations auditors make are valid. An auditor’s reputation is dependent upon audits that are legitimately performed and accurately reported. If audits are perceived…
Insurance Discrimination – Against the Provider Author: Jeana M. Singleton, Esq. When the concept of “insurance discrimination” rears its ugly head, we often think of it in the context of when an insurance company treats some people differently than others based on protected classes, such as race, national origin, sex, or religion. Sometimes, this type…
Understanding Independent Interpretation in E/M Coding: Three Essential Requirements Shannon O. DeConda, CPC, CPMA, CEMA, CPA-EDU October 4, 2024 In the realm of Evaluation and Management (E/M) coding, independent interpretation is an often misunderstood component of the Medical Decision Making (MDM) table. Proper documentation of independent interpretation is required to impact the MDM and, consequently,…