February 7, 2020 | By Pam Vanderbilt, CPC, CPMA, CPPM, CPC-I, CEMC, CEMA, CEMA-O Previously we explored the 2021 changes that effect how diagnoses will be scored. Today we will dive into the changes to the data element of MDM. We know the year 2021 will bring significant changes to how we…
February 14, 2020 | By Pam Vanderbilt, CPC, CPMA, CPPM, CPC-I, CEMC, CEMA, CEMA-O Next year will see the implementation of significant changes to E&M guidelines, reducing the emphasis on the history and exam components while highlighting medical decision making (M.D.M.). In our last audit tip on the E&M changes, we discussed…
February 21, 2020 | By Pam Vanderbilt, CPC, CPMA, CPPM, CPC-I, CEMC, CEMA, CEMA-O In the first three articles of this series, we explored how the 2021 E&M changes to office visits will affect each element of medical decision making (MDM): diagnoses, data, and the table of risk. In this article, we…
May 22, 2020 | By Pam Vanderbilt, CPC, CPMA, CPPM, CPC-I, CEMC, CEMA, CEMA-O NAMAS, like other professional organizations, has a network of compliance professionals who are diligently culling through the multiple interim final rules and daily barrage of e-mails about temporary relaxation of guidance for reporting provider services. This information has become nightly…
July 17, 2020 | By Pam Vanderbilt, CPC, CPMA, CPPM, CPC-I, CEMC, CEMA, CEMA-O By now everyone has heard that we will no longer have to score history and exam components to determine an E&M code level for the office/outpatient CPT codes 99202-99215, beginning January 1, 2021. Instead, we will use new methods for…
May 7, 2021 | By Frank Cohen, Director of Analytics and Busines Intelligence It looks like the feds are moving quickly into recoupment audit mode in regards to telehealth and other services reported during the COVID-19 declared Public Health Emergency (PHE). Starting sometime the end of the first quarter of 2020, HHS came out…
March 6, 2020 | By Paul Spencer, CPC, COC Something of a preemptive celebration is currently going on in the world of physician documentation. As we know, beginning in January 2021, CMS will modify documentation guidelines for evaluation & management services to put more of an emphasis on medical decision making, rather than…
March 13, 2020 | By Jesse Overbay, JD Readers of this newsletter and followers of the incredibly talented individuals on the NAMAS team know that conducting internal monitoring and auditing remains one of the seven fundamental elements of an effective compliance plan.[1] Monitoring and auditing within a medical practice or hospital system encompasses many…
March 20, 2020 | By Shannon DeConda, CPC, CPC-1, CPMA, CEMC, CMSCS Step 1: Telehealth Consent In order to conduct a patient encounter as a telehealth service, the patient must consent to this modality. The consent should include the patient’s explicit agreement to being treated via telehealth rather than in a face-to-face encounter. Each…
March 27, 2020 | By Grant Huang, CPC, CPMA The recent coronavirus crisis has brought non-face-to-face services to the forefront of coding and billing conversations. With the entire healthcare industry focused on caring for patients during an unprecedented and fast-moving pandemic, the goal of increasing patient access while reducing the risk of spreading infection…