A question that I get asked repeatedly, that I haven’t taken the time to address in a long time, came up on a webinar that I was doing for orthopedic executives and coders. What happens when a provider sees a patient and then later finds out that they were a resident of a Skilled Nursing…
May 26, 2023 | By Stephanie Allard, CPC, CEMA, RHIT Most of us, if not all of us, have heard the statement, “If it isn’t documented, then it wasn’t performed.” While I know this is often the perspective of payors, I cringe when I hear this, thinking about all the providers that I work…
May 19, 2023 | By Terry A. Fletcher BS, CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, ACS-CA, SCP-CA, QMGC, QMCRC, QMPM Unless you have been climbing Mount Everest alone with no cell or Wi-Fi services for the past few months, I am certain you have heard of ChatGPT and its use as a form…
May 5, 2023 | By Stacie L. Buck, RHIA, CCS-P, RCC, RCCIR, CIRCC It is no secret that interventional radiology is one of the most difficult specialties for coders and auditors to master. In particular, coding correctly for embolization procedures can be tricky due to the multiple coding considerations involved. This article provides tips…
March 24, 2023 | By Jennifer McNamara, CCS,CPC,CDEO,CPMA,CRC, COSC,CGSC,COPC, AAPC Approved Instructor | Director of Education and Coding, oncospark When auditing medical charts, there are significant differences between evaluation and management services (E/M) and surgical services. These differences are essential to understand to ensure that the medical documentation is accurate, complete, and compliant with regulatory requirements.…
January 6, 2022 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT Leaning into a new year, as I sit to write this audit tip, I am reflecting on questions that we have been asked throughout 2022 and wondering if any of these might help everyone launch a new year with greater perspective. Well, one…
September 9, 2022 | By Stacie L. Buck, RHIA, CCS-P, RCC, RCCIR, CIRCC Each day thousands of patients are undergoing one or more therapeutic interventions, the most common ones being angioplasty, stent and atherectomy of the lower extremity arteries to treat various forms of peripheral vascular disease. This article will highlight the most common…
You know, sometimes, as coders and auditors, we’re the last ones to know about new things that come into the office, but sometimes we should be the first. This past week I got an e-mail from a friend (who is also a client and NAMAS member) who said their office received a new type of…
I would like to make things right the first time so often, that they have errors and I need to make corrections -and the same is true for providers. In this post, I would like to approach the topic of addendums. The thing about addendums is… there are no clear-cut rules – except how to…
April 8, 2022 | By Sean Weiss, CHC, CEMA, CMCO, CPMA, CPC-P, CMPE, CPC Four months into 2022 and the question is: How far along is your audit of high, medium, and low-risk services? If you are like most practices or health systems, something always gets in the way and causes audits to take…