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Category Archives: E/M Coding & Auditing

How (and when) to credit “Decision Regarding Hospitalization”

E/M Coding & Auditing, Evaluation & Management: 2021 & BeyondBy NAMASJanuary 29, 2021

  January 29, 2021 | By Scott Kraft, CPMA, CPC One of the big changes in the new E/M Documentation Guidelines for 2021 for office and outpatient service codes 99202-99215 is the new high-risk category of “Decision Regarding Hospitalization.” As an auditor, the first thing I thought about were the situations in which a very…

The Year of the Audit: Stand Your Ground with Payers

Compliance, E/M Coding & Auditing, Legislative Action, Payer RulesBy NAMASJanuary 22, 2021

  January 22, 2021 | By Sean M. Weiss, CHC, CMCO, CEMA, CPMA, CPC-P, CMPE, CPC Welcome to 2021, “y’all” – as we say down yonder in the beautiful South! Let me begin by making it clear that the issues discussed in this article are not specific to any particular commercial or federal healthcare payer…

Auditing Critical Care Services

E/M Coding & Auditing, Procedural Coding & AuditingBy NAMASJanuary 15, 2021

  January 15, 2021 | By Stephanie Allard, CPC, CEMA, RHIT CMS defines critical care as “the direct delivery by a physician(s) of medical care for a critically ill or injured patient. The care of such patients involves decision making of high complexity to assess, manipulate, and support central nervous system failure, circulatory failure, shock-like…

Better late than never: Stimulus bill salves pain of conversion factor cut, also delays G2211

E/M Coding & Auditing, News & Events, Payer RulesBy NAMASJanuary 8, 2021

January 7, 2021 | By Grant Huang, CPC, CPMA The 2021 Physician Fee Schedule (PFS) had included the largest one-year reduction to the Medicare conversion factor (CF) in more than 20 years, but it won’t actually take effect because the CF is being increased as a result of provisions in the recently passed stimulus legislation.…

The SOAP Note Revisited in 2021

E/M Coding & Auditing, Evaluation & Management: 2021 & Beyond, Procedural Coding & AuditingBy NAMASJanuary 1, 2021

January 1, 2021 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT While conducting a 2021 E&M Physician Training event for a client, like right in the middle of the session, I had an epiphany. Now maybe you have already had it- but I thought- WOW- we have made the full circle right back around…

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