Dec 1st, 2012
By Amy Lee Smith, MBA, CPC, CPC-H, CPMA, CIA, CRMA  Preparing for, and responding to, recovery audit contractor (RAC) reviews can be intimidating. You can lessen the pain, however, by understanding Medicare billing and coding rules and requirements, and being proactive in implementing controls to ensure compliance. RACs Review Across the Nation Section 302 of ...
Nov 1st, 2012
Melissa Brown, CPC, CPC-I, CFPC, RHIA  As I watched the summer Olympics this past August, I couldn’t help but think about the correlation to the trend for “pay for performance,” or P4P, we face in health care. The Olympians used various approaches to prepare themselves for the Olympics, but they all had one goal in ...
Nov 1st, 2012
By Stephen C. Spain, MD, FAAFP, CPC Angela “Annie” Boynton, BS, CPC, CPC-H, CPC-P, CPC-I, RHIT, CCS, CCS-P, CPhT Editor’s note: Health care reform brings a number of new concepts to coding, billing, compliance, and practice management. The most far reaching—especially from an organizational point of view—are accountable care organizations (ACOs). Below is the first ...
Nov 1st, 2012
By Jaci Johnson CPC, CPMA, CEMC, CPC-H, CPC-I Whether performing an audit or providing education, when it comes to evaluation and management (E/M) coding, your first consideration should be accurate, compliant information and results. Choose Reliable Resources Our reliable resources are the Centers for Medicare & Medicaid Services (CMS) 1995 and 1997 Documentation Guidelines for ...
Nov 1st, 2012
By G.J. Verhovshek, MA, CPC  In most circumstances, you would not code separately for suture removal. There isn’t a dedicated CPT® code for suture removal, and both the American Medical Association (AMA) and the Centers for Medicare & Medicaid Services (CMS) consider suture removal to be an integral part of any procedure that includes suture placement. ...