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Category Archives: E/M Coding & Auditing

E/M 2021 Guidelines and the Importance of SDOH

E/M Coding & Auditing, Evaluation & Management: 2021 & BeyondBy NAMASJune 4, 2021

  June 4, 2021 | By Cheryl A. Cyrus, RHIT, CPMA, CDEO, CRC, Comforcehealth, Quality Assurance Auditor As of January 1, 2021, we have been given new Evaluation and Management Guidelines for Outpatient Office and Ambulatory services that encompass specific areas of risk defined in the SDOH (Social Determinants of Health).  As a Profee auditor,…

Use of “Time” in Evaluation Management and Coding

E/M Coding & Auditing, Evaluation & Management: 2021 & BeyondBy NAMASMay 14, 2021

  May 14, 2021 | By Jill Young, CPC, CEDC, CIMC The time has come for you to consider the “new time” method to determine the evaluation and management (E&M) coding for your office and other outpatient services. I use the phrase “new time” to differentiate it from the “old time” concept you are accustomed…

Feds Moving Quickly Into Recoupment Audit Mode

Compliance, COVID-19, E/M Coding & AuditingBy NAMASMay 7, 2021

  May 7, 2021 | By Frank Cohen, Director of Analytics and Busines Intelligence It looks like the feds are moving quickly into recoupment audit mode in regards to telehealth and other services reported during the COVID-19 declared Public Health Emergency (PHE).  Starting sometime the end of the first quarter of 2020, HHS came out…

Clear At Last? AMA Releases Clarifications to 2021 E/M Guidelines

E/M Coding & Auditing, Evaluation & Management: 2021 & BeyondBy NAMASMarch 26, 2021

  March 26, 2021 | By Grant Huang, CPC, CPMA If you thought some of the language in the 2021 E/M guidelines was confusing, you’re not the only one: The AMA has gotten enough questions about its new guidelines to issue a six-page document packed with clarifications and corrections. The document also includes an additional three pages…

External Reviews are For More Than Proof of an Audit

Compliance, E/M Coding & Auditing, Procedural Coding & AuditingBy NAMASMarch 5, 2021

  March 5, 2021 | By Stephanie Allard, CPC, CEMA, RHIT When I begin to work with a new client on an auditing project, I like to set up a meeting with them before we begin, to talk through the steps that I take as an auditor and to discuss their reason for the audit…

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