November 22, 2024 | By Jordan Johnson, MSHA Coding for oncology services is an intricate task, requiring attention to detail, a deep understanding of clinical workflows, and the ability to navigate multiple systems and payer requirements. In radiation oncology, services often span multiple months, with a patient’s treatment involving 30-50 Current Procedural Terminology (CPT)…
Preventative Testing – Unique Risk Stories – Listening to your patients By Jill Young CEMC, CPC, CEDC, CIMC September 27, 2024 I am going to tell you a story about my family and their journey with Preventive Testing and colon cancer. Names have been changed to protect the innocent and some facts may have been…
Getting it right: HCC in Primary Care Rhonda Buckholtz CPC, CPMA, CDEO, CRC, CHC, COPC September 20, 2024 Many of us have a love/hate relationship depending on your role in healthcare. From a provider standpoint, most often we think of these as an administrative burden with no upside. However, a shift in thinking is needed…
The Well Woman Exam Crystal Tompkins CDEO, CPMA, CPC, CRC, COBGC, and Educator and Auditor September 13, 2024 I will never forget the wonder of being asked to write an article for NAMAS. The nerd in me was ecstatic, and the auditor/coder in me was completely in shock. After that feeling subsided, reality quickly set…
Safeguarding Medical Necessity in Non-face-to-face Exchanges Anna McGregor CLP, CPC, CPCO, CPMA, CPA-RA, CEMC, CEMA September 6, 2024 Has there been a moment when auditing an encounter when one wondered if this service was necessary because a reasonable indication for medical services was not identified? Should medical necessity be identified as the appropriateness of a non-face-to-face…
Navigating Prescription Drug Medical Weight Loss Stephanie Allard, CPC, CEMA, CPA-RA, RHIT August 23, 2024 This year, a recurring issue is continuing to pop up in the audit reviews that I am completing for clients. The issue is related to medical weight loss and what I think is a complete misunderstanding in the industry regarding…
July 26, 2024 By:Pamela Warren, MHA, COC, PCS, CPC, Fellow Auditing Surgical Services While E&M auditing continues to be the industry favorite for professional medical auditors in this field, there are several reasons and opportunities to audit surgical services. However, even though many surgeons spend a fair amount of office time in consultation with…
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…
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…
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…