In 2021, the American Medical Association implemented significant changes to the Evaluation and Management (E/M) code sets applicable in the office/outpatient setting. Those changes, which were intended to simplify coding by placing more emphasis on complexity and...
As we have seen since April 2021, we are still being influenced by the Great Resignation or the Big Quit. COVID-19 was a wake-up call for many people in general, but even more so for employees who were not satisfied with their current roles in the workplace. Employees...
The most recent significant changes to the E&M coding guidelines occurred in 2021 allowing physicians to choose between medical decision-making and time-based reporting for their services. Now, it appears we are in store for additional changes to begin January...
You’ve received a request for medical records from a payer, who is going to conduct an audit on your claims. Your Electronic Health Record (EHR) system is excellent, the notes are voluminous, your providers are well-versed at coding. If anything, you under code! You...
These are recaps of what they report as some of the trends and realities of compliance today
The innumerable horror stories related to payer audits have given rise to a new trend of undercoding, by intent! Many providers would rather be safe than sorry, all in the name of keeping their good names off the radar. However, undercoding can backfire, resulting in...
When the COVID-19 pandemic reached our shores, it instantly changed the way we lived and worked. Many businesses were shuttered, and most people have yet to return to their offices since the March 2020 lockdowns. Virtual meetings, remote learning and limited socially...
A coding audit can be immensely stressful. Even though many practices do well, there are cases (some of them rather well known) involving fraudulent behavior which result in large recoupments and overpayment extrapolations. How well you’ll do depends at least in...