October 3, 2023 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT Have you seen the new AMA Smart Brief on Modifier 25 that was released on August 17th? That’s what I want to talk to you about today. I want to break down the information because I specifically noticed there is a stark…
Let’s have a conversation about the data column on MDM. Specifically, what I’d like to address is imaging services. When a provider performs an x-ray while seeing a patient, and they are not going to bill a professional component of that test, how do we count that service? Is that service something we can count?…
September 2, 2022 | By Bryan Meek, Esq., Brennan, Manna, and Diamond Patients missing their healthcare appointments without adequate notice can cost practices a lot of money, as well as deprive patients of necessary care. While one solution to mitigate this damage is to charge patients for missed appointments, policies should be written…
February 25, 2022 | By Bryan Meek, Esq., Brennan, Manna, and Diamond The Department of Health and Human Services published three parts to the No Surprises Act towards the end of 2021, which took effect January 1, 2022. The Act is intended to protect consumers from “balance billing,” which occurs when a patient receives…
February 19, 2021 | By David Carpenter Critical care billing is relatively simple. Documentation requires three items – The patient is critically ill. What the provider is doing to treat or prevent organ system failure or compromise. How much time the provider spent providing critical care. While critical care billing is relatively simple,…
April 14, 2023 | By David Glaser It’s almost a staple at conferences attended by coders: you should have insurance! And be careful to make sure you aren’t going to jail! But while these scary speeches may be common, that doesn’t make them accurate. The reality is that it is very, very rare…
September 22, 2023 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT Let’s get uncomfortably honest. With continued reimbursement cuts, like this year’s $9-12k per provider E/M cut, organizations cannot sustain 100% coding validation. Now, let’s get brutally honest. This is compounded by a lack of truly skilled and knowledgeable coders looking to fill the…
August 28, 2020 | By David Glaser, JD For the compliance-oriented, there is something rewarding about developing policies. It feels like an accomplishment, demonstrable proof of a desire to do the right thing. But speaking as a lawyer, I am convinced that most policies hurt, rather than help, the organization that adopts them. There…
February 17, 2023 | By Brenda Edwards, CPC, CDEO, CPB, CPC-I, CEMC, CRC, CMRS, CMCS Happy Friday! We have our first month of 2023 behind us which means the first of the claims for the new year have been submitted. Here’s the $100,000 question – are you claims paying appropriately with the 2023 Evaluation…
August 26, 2022 | By Beth Schleeper, COC, CPC, CPCO, CDEO, CPB, CPMA, CPPM, CRC, CPC-I, CEMC, CEMA Most of us are very aware of the risks inappropriate bundling modifier usage can cause, but when is the last time we thought about how other modifiers may put us at risk? For example, what about our surgical modifiers…