May 26, 2023 | By Stephanie Allard, CPC, CEMA, RHIT Most of us, if not all of us, have heard the statement, “If it isn’t documented, then it wasn’t performed.” While I know this is often the perspective of payors, I cringe when I hear this, thinking about all the providers that I work…
May 19, 2023 | By Terry A. Fletcher BS, CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, ACS-CA, SCP-CA, QMGC, QMCRC, QMPM Unless you have been climbing Mount Everest alone with no cell or Wi-Fi services for the past few months, I am certain you have heard of ChatGPT and its use as a form…
May 12, 2023 | By Scott Kraft, CPMA, CPC The E/M Documentation Guidelines implemented in 2021 essentially place, time and medical decision making on equal footing. When visit time is documented, the service can be coded based on whichever of time and medical decision making is most favorable to the provider. This has led…
March 28, 2023 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT With the adaptation of 2021 Guidelines and the reduction in documentation requirements, many coders and auditors had thought the use of copy and paste may begin to phase out. Unfortunately, this has not been the case, primarily because many providers are still…
May 20, 2022 | By Toni Elhoms, CCS, CPC, CPMA, CRC I know I am not the only one who is completely appalled by the recent bombshell story on Cigna’s shady claims adjudication practices. ProPublica recently published a scathing article that pulls back the curtain on “PXDX” – a cost-containment strategy deployed by Cigna…
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…