Getting it right: HCC in Primary Care Rhonda Buckholtz CPC, CPMA, CDEO, CRC, CHC, COPC September 20, 2024 Many of us have a love/hate relationship depending on your role in healthcare. From a provider standpoint, most often we think of these as an administrative burden with no upside. However, a shift in thinking is needed…
March 1, 2024 | By: Crystal May, CCS, CPC, CDEO, CPMA, CRC, Approved Instructor Breaking Down ICD-10-CM 7th Characters for Traumatic Fracture Care: Coders often get overwhelmed with coding traumatic fractures, typically due to the numerous 7th characters available. But coding them isn’t as scary as it seems once you understand how they break down.…
December 15, 2023 | By Stephanie Allard, CPC, CEMA, RHIT One area that keeps coming up in my conversations and education sessions is the definition and understanding, or misunderstanding, of the concept of a “problem addressed” during an encounter and how that is applied to E/M services. As treating practitioners document and as we…
November 1, 2023 | By Shannon O. DeConda We conducted a comprehensive survey to gain a better understanding of the ongoing debate in the industry about whether the E/M level of services is increasing or decreasing with the latest guidelines implemented in 2021. While we acknowledge that the survey isn’t scientifically conclusive, we urge organizations…
October 29, 2021 | Edward Townley CPC, CEMC, CUC, ROCC, Founder, Cogent9 Consulting This is the time of year that we receive our new coding manuals. First the ICD-10, which becomes effective October 1 and CPT and HCPCS manuals which come nearer to the end of the calendar year, and effective January 1. For…
October 20, 2023 | By Jennifer McNamara, CCS, CPC, CDEO, CPMA, CRC, COSC, CGSC, COPC, AAPC Approved Instructor | CEO, Healthcare Inspired, LLC Every year we get updates to the Official Guidelines for Official Guidelines for Coding and Reporting, and this year for reporting year 2024 we received an update regarding Chapter 21 for…
October 13, 2023 | By J. Paul Spencer, CPC, COC Way back in 1976, as an elementary school kid in the suburbs of Philadelphia, I came across a book in the library called 2010: Living in the Future. In my then-current world of AMC Pacers and seersucker suits, the book promised great things. Apparently,…
Amy C. Pritchett, CCS, CRC, CPA-RA, CPC, CPMA, CPCO, CDEI, CDEO, CDEC, CANPC, CASCC, CMPM Manager, HCC Coding/Audit & Education Services, Pinnacle Enterprise Risk Consulting Services AAPC Fellow |Approved Instructor |ICD-10-CM/PCS Trainer On March 31, 2023, the Centers for Medicare and Medicaid Services (CMS) released the CY 2024 Medicare Advantage (MA) Capitation Rates along…
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…
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…