April 3, 2020 | By Sean Weiss, CHC, CEMA, CMCO, CPMA, CPC-P, CMPE, CPC Happy Friday – we made it through another week of change, after change, after change. There have been a lot of side-stepping and dancing around to get to where we are now. I have told clients for weeks that there…
October 23, 2020 | By Grant Huang, CPC, CPMA It’s not even 2021 yet, but gray areas have already surfaced in the 2021 E/M documentation guidelines, as more and more coders and auditors read the fine print. The 2021 guidelines, which will apply only to outpatient/office visit codes 99202-99215, are being implemented in part…
December 15, 2020 | By By Grant Huang, CPC, CPMA At long last, CMS has published its Medicare Physician Fee Schedule (PFS) final rule, and while some of the provisions will be widely felt across many specialties, there are no major or unexpected deviations from the proposed rule. The agency typically releases the PFS…
May 1, 2020 | By Stephanie Allard, CPC, CEMA, RHIT Over the years I have found that one of the main risks to an organization are employees who get comfortable in their positions to the point where the explanation for or response to an audit variance is “that is how we have always…
May 8, 2020 | By Paul Spencer, CPC, COC Time, as it applies to procedures and services, is a vastly misunderstood portion of the Resource Based Relative Value Scale (RBRVS), the methodology used to generate the relative value units (RVUs) that determine the payment for every CPT code. For many years, information on the…
May 29, 2020 | By Kari M Keller, CCS, CPC, CPMA, CEMA, CIRCC, CPC-I, CCDS-O | Senior Manager Coding Quality, Inova Health System Those who know me best know that I am an absolute optimist. I can find the positive in almost everything. So, what has this stay-at-home order impacted? We slowed our lives down. We…
June 19, 2020 | By Grant Huang, CPC, CPMA The hype surrounding next year’s implementation of new guidelines for documenting and coding Evaluation & Management (E&M) services has revolved around the virtual elimination of the history and physical exam as key components of code selection. But some of the lesser-known changes involving…
July 24, 2020 | By Sean Weiss, CHC, CEMA, CMCO, CPMA, CPC-P, CMPE, CPC Here we are, nearly at the end of July 2020 and we are neck deep in the process of trying to determine the true impact of the 2021 Evaluation and Management (E&M) Services changes. Here’s the deal from my perspective:…
August 21, 2020 | By Jesse Overbay, JD On March 13, 2020, the President of the United States issued an emergency declaration under the Stafford Act to declare a national health emergency, setting in motion a chain of events for the Centers for Medicare and Medicaid Services (“CMS”) and our entire healthcare system that…
November 27, 2020 | By Grant Huang, CPC, CPMA Auditing evaluation and management (E/M) services furnished by resident physicians under the Medicare Primary Exception (PCE) already required a firm grasp of attestation and coding rules – but now COVID-19 throws another wrench into the works. In this audit tip, we will review the rules…