April 7, 2023 | By Rachel Rose, JD, MBA Overview Whenever I present, which is often, I often receive follow-up questions from participants regarding resources to utilize when creating, reviewing, and/or supplementing a compliance program, including relevant policies and procedures. One resource which should be utilized is the Health Care and Public Health Sector…
March 24, 2023 | By Jennifer McNamara, CCS,CPC,CDEO,CPMA,CRC, COSC,CGSC,COPC, AAPC Approved Instructor | Director of Education and Coding, oncospark When auditing medical charts, there are significant differences between evaluation and management services (E/M) and surgical services. These differences are essential to understand to ensure that the medical documentation is accurate, complete, and compliant with regulatory requirements.…
March 17, 2023 | Terry A. Fletcher BS, CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, ACS-CA, SCP-CA, QMGC, QMCRC, QMPM With the end of the PHE comes the planning, due diligence of correct information, and then re-training of physicians and staff to make sure everything is consistent and correct practice wide. Here are a…
March 10, 2023 | By Bryan Meek, Esq., Brennan, Manna, and Diamond OVERVIEW: The Eliminating Kickbacks in Recovery Act (“EKRA”), part of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (“SUPPORT”) for Patients and Communities Act, was passed in 2018. Since its passing, there has been very limited guidance as to how…
May 3, 2022 | By Michele Strickland, CPC, CEMA Research has been on my mind a lot lately. As auditors it is very important that we continually “exercise” our research muscle to make sure we are looking at our auditing from all angles. Rarely is our world black and white, so it is very…
We often spend a lot of time talking about prescription drug management. Today in our “Take” we will spend time addressing over-the-counter medication. This question was submitted to me by Kelly, who works in a dermatology practice, but her question is relevant no matter your specialty. Kelly’s question is about a physician who is using…
February 24, 2023 | By Sonal Patel, CPMA, CPC, CMC, ICDCM Well, the time is finally here! 2023 has ushered in a new standard for how we look at evaluation and management (“E/M”) services. Physicians, providers, coders, auditors, educators, and compliance professionals alike are finally able to utilize much more than the “bean-counting” methods…
In the expansion category of the 2021 documentation guidelines, there’s some information that may be a little confusing that would like to review with you in Today’s Take. On page 23, under Initial Hospital Inpatient or Observation Care, under the New and Established Patient, there’s a paragraph that reads a little confusing: “If a consultation…
February 10, 2023 | By Grant Huang, CPMA, CPC The realm of E/M auditing is vast, and 2023 will bring more work here than before thanks to CPT’s extensive revisions to its E/M guidelines for inpatient, facility, and home visit services — now in effect. Both compliance professionals and providers must always keep in…
THE RECAP An announcement on Monday, January 30th, by the OMB (Office of Management and Budget), and the White House, stated that they plan to end the COVID-19 national emergency and public health emergency on May 11th. The end of the emergency declarations would signal a new chapter in the Biden administration’s response to the…