Category Archives: Coding & Billing
What We’re Reading – Inappropriate Billing, Fraud Gaining Scrutiny
Despite the pandemic, the U.S. Department of Health and Human Services – Office of the Inspector General (HHS-OIG) has not missed a beat. Regulators are still focusing on fraud and non-compliance. This article refers to a bulletin, issued in February … Read Full Post
CMS Releases “Telehealth for Providers: What You Need to Know”
Despite all the information about telehealth (TH) published and available since the Spring of 2020, misconceptions and misunderstandings still exist and can be costly in lost revenue and billing error recoupments. CMS has published a very comprehensive guide to TH … Read Full Post
OIG Pursues Audits of Part B Telehealth
The Office of Inspector General’s work plan for 2021 includes audits on Medicare Part B telehealth (TH) use. Phase one of these audits focuses on assessing, among other things, whether E/M services conducted via TH meet Medicare requirements. Phase two … Read Full Post
Billing No-Nos: Careless Eligibility Checks
Eligibility checking is one of the foundations of proper billing. This is the process by which the practice verifies the insurance status of the patient before services are rendered; the second aspect of eligibility checks is careful examination of the … Read Full Post
Billing No-Nos: The Uncredentialed Provider
Welcome to this series on billing errors. Over the next few weeks, we will bring you common issues we continue to see when working with medical practices large and small. The first “no-no” to explore is the uncredentialed provider. We … Read Full Post
Supporting a Diagnosis of Angina Pectoris
In a primary care setting, we sometimes encounter patients who have been diagnosed with angina pectoris and are being followed by the primary care practitioner (PCP). In this blog, we will share some of the most common issues regarding this … Read Full Post
“Not-Assessments:” Misconceptions about Assessing Conditions
We educate a good bit about documentation of a proper assessment, use the acronyms M-E-A-T or T-E-A-M and still see skimpy notes with an “assessment” that doesn’t pass muster – from providers who, by now, should be on board with … Read Full Post
OIG Says CMS Misses the Forest for the Trees
In honesty, OIG didn’t come out and make that statement, but after reading a just-released report, missing the forest for the tress is exactly what seems to have happened. The Office of Inspector General (OIG) provides auditing services for the … Read Full Post
What We’re Reading – CDC Releases Updated Coding Guidelines
A recent article summarized updated ICD-10-CM coding guidelines for COVID-19 and vaping disorders. Here are some bullet points to keep in mind: For confirmed COVID cases, use U07.1, with documentation supporting the diagnosis. A positive test result is not required. … Read Full Post
The ABCs of Coding
Imagine trying to have a conversation with someone who only speaks a foreign language and having no access to a translator. Tough to do, right? You’d need basic use and understanding of relevant words in the foreign language and your … Read Full Post