Most E/M auditors work diligently to hone their craft. They are experts on the CMS 1995 and 1997 Documentation Guidelines, they can spot a troublesome template a mile away, and they work hard to ensure that physicians comply with stringent regulations and rules. They are generally careful, decisive, and thorough communicators. The effort generally pays ...
In Audit
Mar 16th, 2015
By Charla Prillaman, CPCO, CPC, CPC-I, CCC, CEMC, CPMA In February, we examined how “labels” might cause an incorrect count of organ systems examined if an auditor doesn’t take care to read the details beyond the labels. For purposes of this discussion we will assume that the examination and complexity of MDM meet the proposed ...
Recent changes in how the Centers for Medicare & Medicaid Services (CMS) allows you to calculate evaluation and management (E/M) service levels are a benefit to providers, especially those who manage patients with multiple chronic conditions. AAPC’s Managing Editor, G. John Verhovshek, CPC, recently published an article with the California Medical Association, in which he ...
Often, a patient who arrives for a “preventive” service (i.e., a well patient exam) will also mention a problem or other health issue that he or she is experiencing. AAPC’s Managing Editor G. John Verhovshek, MA, CPC, recently published an article with the California Medical Association in which he expounded on the necessary elements behind ...
Dec 15th, 2012
Every October the Office of Inspector General (OIG) releases a new Work Plan, one of three OIG publications designed to help coding and compliance professionals ensure that claims are correctly and appropriately submitted for adjudication. Charla Prillaman, CPC, CPCO, CPMA, CPC-I, CCC, CEMC, recently wrote an article on the 2013 OIG Work Plan which was ...