October 3, 2023 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT Have you seen the new AMA Smart Brief on Modifier 25 that was released on August 17th? That’s what I want to talk to you about today. I want to break down the information because I specifically noticed there is a stark…
September 4, 2020 | By Brenda Edwards, CPC, CDEO, CPB, CPC-I, CEMC, CRC, CMRS, CMCS Is anybody not aware of the Evaluation and Management (E/M) changes coming in January 2021? Have you asked your administrator, managers, front office, back office, and providers if they are ready for these major changes? Anybody that touches CPT® 99202-99215…
February 19, 2021 | By David Carpenter Critical care billing is relatively simple. Documentation requires three items – The patient is critically ill. What the provider is doing to treat or prevent organ system failure or compromise. How much time the provider spent providing critical care. While critical care billing is relatively simple,…
January 10, 2020 | By David Glaser Skepticism is a vital trait in the coding and billing process. Constant questioning is necessary because when you receive guidance from consultants and contractors it may be both clear and categorical, but it’s possible that upon objective review, you will realize it is also cockamamie. For…
September 22, 2023 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT Let’s get uncomfortably honest. With continued reimbursement cuts, like this year’s $9-12k per provider E/M cut, organizations cannot sustain 100% coding validation. Now, let’s get brutally honest. This is compounded by a lack of truly skilled and knowledgeable coders looking to fill the…
November 20, 2020 | By Brenda Edwards, CPC, CDEO, CPB, CPC-I, CEMC, CRC, CMRS, CMCS The days of 2020 are winding down and I don’t know that any of us are going to be sad to see it go. While saying goodbye to 2020 and hello to 2021, we also say hello to the…
February 17, 2023 | By Brenda Edwards, CPC, CDEO, CPB, CPC-I, CEMC, CRC, CMRS, CMCS Happy Friday! We have our first month of 2023 behind us which means the first of the claims for the new year have been submitted. Here’s the $100,000 question – are you claims paying appropriately with the 2023 Evaluation…
October 28, 2022 | By Brenda Edwards, CPC, CDEO, CPB, CPC-I, CEMC, CRC, CMRS, CMCS We are all excited about the upcoming 2023 E/M changes, aren’t we? Well, I can say, as a coder and auditor, I am! I’ve been in this E/M world for about 35 years. Things were easy prior to 1995,…
May 29, 2020 | by Anna McGregor, CLP, CPC, CPCO, CPMA, CEMC, CEMA | Director for Coding Integrity, Texas Tech University Health Sciences Center/School of Medicine Like a sandstorm, CMS has clouded our coding world in chaos, leaving us to ponder whether all these new flexibilities will become the new standard. Leading up…
March 12, 2021 | Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content, innoviHealth Because deaths due to drug overdose is a nationwide epidemic, federal, state, and private organizations created substance use disorder (SUD) programs to treat patients who abuse alcohol or other illicit substances, or who have a history of prolonged…