Medical practices receive many communications from payers that aren’t indicative of a problem. A payer needs more information to process a claim. Or, … [Read more...]
2018 CERT Analysis
CMS has not released a full Comprehensive Error Rate Testing (CERT) report since 2016. But, the 2018 supplemental report provides ample information … [Read more...]
Incident to and change to medications
Question: A CodingIntel member writes: "I am getting mixed information about incident-to and I was wondering if you could weigh in? If a NPP … [Read more...]
Compliance issues in ICD-10 coding for risk based contracts and HCCs
Everyone loves to read the general guidelines at the front of the ICD-10 book, right? No? Well, here’s an excerpt. “Code all documented conditions, … [Read more...]
7 sure fire ways to owe the government $4 million in fines and repayments | Coding Compliance
Most practices aren’t looking to pay the government any money in fines and repayment because of coding errors. Two recent OIG settlements described … [Read more...]
What is a Coverage Policy?
National Coverage Determinations (NCD) and Local Coverage Determinations (LCD) are Medicare’s coverage policies. Private payors publish their own … [Read more...]
This practice paid Medicare $4.48 million
Do you sign up for email lists and then wonder why you did it? We all do, don’t we? But, one email I always read is the one from the Department of … [Read more...]
So Your Payer Has Requested Records: Billing high level services
Documentation is key when billing high level services. What do clinicians need to know? What role do education and internal audits play? This short … [Read more...]
Medicare Rules for Incident To and Shared Services
Whose provider number is being used to bill services to the insurer, or to Medicare? This is a compliance risk area often overlooked. This 10 minute … [Read more...]
Medical Billing: Avoiding the Three Deadly Sins of Compliance
What is the real risk of compliance audit from commercial payers or from Medicare? This short video addresses three specific areas of risk and offers … [Read more...]
Billing for Services Provided by Medical Students
Updated September 18, 2018 Coding. Why does it keep changing? This video has been removed because the rules related to these services have … [Read more...]
Skype ≠ Telemedicine
I got a call from a vendor trying to develop a video conferencing product for a physician to use to talk to a patient who is at home. He said “I’m … [Read more...]
Clues That Your Scribe is in Disguise
An Overview of Medical Scribes and Scribe Billing Rules Medical scribes are in the news as a way for physicians to more effectively care for patients … [Read more...]
Risky business, or tempest in a teapot: Are you an audit target?
Some days, it appears we compliance and coding folks are like the boy who cried wolf. We see shadows around every corner. We emulate Captain Kirk, … [Read more...]
No Chart Left Behind: Deadline to Complete Medical Records
Years ago, I worked with a physician who was chronically behind in dictating his notes. The charts were crammed into boxes by date, lining the walls … [Read more...]
The Physician Who Never Sleeps: Using the Correct NPI
Years ago, I worked with an Orthopedist who needed hours less sleep than I or the average person needed. While it would be incorrect to say he never … [Read more...]
Your HPI: it should be longer than a tweet
The history of the present illness should be longer than a tweet and twice as informative. Any twitter users out there? If so, you know that 140 … [Read more...]
Avoiding Unforced Errors While Using your EMR
“I have a normal exam template that I always use.” All right, I know baseball season is over, and it is hunting season in Vermont, so maybe I … [Read more...]