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,…
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…
February 11, 2022 | Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content, innoviHealth How have you felt when you embarked upon an audit, expecting to find certain basic standards of documentation to be present, but instead found them missing? Do you pull out your favorite red pen, grab a cup of…
March 24, 2023 | By Jennifer McNamara, CCS, CPC, CDEO, CPMA, CRC, COSC, CGSC, COPC, AAPC Approved Instructor | CEO, Healthcare Inspired, LLC One modifier that often raises eyebrows and questions is Modifier 62. This modifier can impact reimbursement and compliance, making it a focal point for audits by the Office of Inspector General…
August 11, 2023 | By Terry A. Fletcher BS, CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, ACS-CA, SCP-CA, QMGC, QMCRC, QMPM | Terry Fletcher Consulting, Inc. | Healthcare Coding and Reimbursement Consultant, Educator and Auditor | Podcast Host, CodeCast®, NSCHBC Edge Podcast, #TerryTuesday TCG Podcast | NAMAS Educational Speaker and Writer A question comes up often regarding…
June 30, 2023 | By Sonal Patel, CPMA, CPC, CMC, ICDCM One of my favorite childhood memories includes learning how to paint. Messy and fun, fingerpainting and potato printing held my attention for years. As I got a little older, I marveled at how I could create masterpieces by using the “paint by numbers”…
June 16, 2023 | By Rhonda Buckholtz, Owner, Coding and Reimbursement Experts Cataract surgeries are the most commonly performed procedure in ophthalmology, and there are many nuances when auditing that you need to keep in mind. If you stay current on the legal cases that are published, you will see that co-management of cataract…
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…