October 1, 2021 | By Grant Huang, CPC, CPMA A year and half into the coronavirus pandemic, confusion still remains over a variety of remote services that are often lumped into the same category as telehealth but have their own unique codes and billing guidelines. CMS has given them the somewhat unwieldy label of…
September 15, 2021 | By Stephanie Allard, CPC, CEMA, RHIT I am looking forward to the NAMAS 13th Annual Auditing and Compliance Conference at the Wyndham Grand Clearwater Beach on December 5th through 8th! This year, I am excited to be a part of the E&M Auditing track on Tuesday, December 7th and…
March 26, 2021 | By Jamee Black, CPC, COC, CPMA The American Medical Association (AMA) recently released changes to the current Evaluation and Management (E/M) documentation guidelines for the Office and Other Outpatient Visit code range (99202–99215). The new guidelines focus on medical decision making (MDM), and are intended to more closely reflect the…
July 16, 2021 | By David Glaser On May 3rd CMS pulled the shared visit language from the Manuals. The government has increasingly recognized that only statutes and regulations can limit Medicare coverage, so when something in the Manuals is not contained in either a federal law or a federal regulation, it is not binding.…
January 31, 2020 | By Pam Vanderbilt, CPC, CPMA, CPPM, CPC-I, CEMC, CEMA, CEMA-O The year 2021 will bring significant changes to how we determine the level of evaluation and management services in the outpatient setting. We will no longer score history and exam elements, instead focusing on medical decision making or…
February 7, 2020 | By Pam Vanderbilt, CPC, CPMA, CPPM, CPC-I, CEMC, CEMA, CEMA-O Previously we explored the 2021 changes that effect how diagnoses will be scored. Today we will dive into the changes to the data element of MDM. We know the year 2021 will bring significant changes to how we…
February 14, 2020 | By Pam Vanderbilt, CPC, CPMA, CPPM, CPC-I, CEMC, CEMA, CEMA-O Next year will see the implementation of significant changes to E&M guidelines, reducing the emphasis on the history and exam components while highlighting medical decision making (M.D.M.). In our last audit tip on the E&M changes, we discussed…
February 21, 2020 | By Pam Vanderbilt, CPC, CPMA, CPPM, CPC-I, CEMC, CEMA, CEMA-O In the first three articles of this series, we explored how the 2021 E&M changes to office visits will affect each element of medical decision making (MDM): diagnoses, data, and the table of risk. In this article, we…
May 22, 2020 | By Pam Vanderbilt, CPC, CPMA, CPPM, CPC-I, CEMC, CEMA, CEMA-O NAMAS, like other professional organizations, has a network of compliance professionals who are diligently culling through the multiple interim final rules and daily barrage of e-mails about temporary relaxation of guidance for reporting provider services. This information has become nightly…
July 17, 2020 | By Pam Vanderbilt, CPC, CPMA, CPPM, CPC-I, CEMC, CEMA, CEMA-O By now everyone has heard that we will no longer have to score history and exam components to determine an E&M code level for the office/outpatient CPT codes 99202-99215, beginning January 1, 2021. Instead, we will use new methods for…