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,…
March 12, 2021 | Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content, innoviHealth Because deaths due to drug overdose is a nationwide epidemic, federal, state, and private organizations created substance use disorder (SUD) programs to treat patients who abuse alcohol or other illicit substances, or who have a history of prolonged…
February 4, 2022 | By Scott Kraft, CPMA, CPC Medicare is making big changes to its policies for billing split/shared visits. While the main policy shifts take place in 2023, there are important changes to the rules for split/shared services in 2022 that must be followed for these services to be covered and billable…
January 21, 2022 | By Sean Weiss, CHC, CEMA, CMCO, CPMA, CPC-P, CMPE, CPC While I am sure you have heard it several dozen times by now, I want to welcome you to 2022 because that is where the pleasantries end. 2022 will see Medical Necessity put front & center not only in audits…
January 7, 2022 | By Toni Elhoms, CCS, CPC, CPMA, CRC It’s our favorite time of the year again – coding and regulatory compliance update season! As I’m sure many of my compliance colleagues can relate, this is the time of the year when we get inundated with “Can I pick your brain” requests…
October 22, 2021 | By Scott Kraft, Auditing Specialist, DoctorsManagement Like many of my auditing colleagues, I entered 2021 with a solid understanding of the rules of the 2021 E/M Documentation Guidelines, but looked forward to seeing how they were applied in practice by the rendering provider. Now that we’ve entered October, one area…
October 12, 2021 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT 2021 AMA guidance indicates that a general systemic symptom such as fever should not be considered a systemic system, but not all fevers fall in this category. The question typically posed is: what is the “magic” range that identifies it as no…
August 27, 2021 | By Jamee Black, CPC, COC, CPMA One of the most difficult determinations of Number and Complexity of Problems Addressed is complicated vs uncomplicated. When selecting Number and Complexity of Problems Addressed, the complication of treatment required should not be considered. The Risk of Complications of Patient Management is where the treatment…
March 26, 2021 | By Jamee Black, CPC, COC, CPMA The American Medical Association (AMA) recently released changes to the current Evaluation and Management (E/M) documentation guidelines for the Office and Other Outpatient Visit code range (99202–99215). The new guidelines focus on medical decision making (MDM), and are intended to more closely reflect the…
July 30, 2021 | By Scott Kraft, Auditing Specialist, DoctorsManagement While payers have increasingly turned away from covering consultation services, this type of billing is not extinct yet. Consultations can be done in the office and inpatient setting, and just as a refresher, are billed when a provider is requesting the professional opinion of…