Oncology Coding Tip: Mastering the Complexities of Radiation and Medical Oncology Billing

  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)…

Safeguarding Medical Necessity in Non-face-to-face Exchanges

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

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…

Attestation Statements – Becoming the Expert

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…

Auditing Complex Surgeries

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…

Auditing the Global Package

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…