In CMS
Aug 8th, 2018
During a July 18, 2018 CMS Twitter™ podcast, CMS National Coordinator for Health Information Technology, Donald Rucker, M.D. defended the new CMS 2019 proposal to make documentation of the History optional for health records. He was asked, “In light of technology’s thirst for data to identify best practices and construct predictive algorithms, is it possible ...
Jul 19th, 2018
By now, many of you have read or at least heard about the proposed changes to E/M service reporting included in the CMS proposed rule relating to the 2019 Medicare Physician Fee Schedule.  This proposal was published in the July 27, 2018 Federal Register.  Because there are only sixty (60) days to submit comments, the ...
In Audit
Jul 17th, 2018
  Proposed changes in the Medicare Physician Fee Schedule (MPFS) for 2019 will change proposed reimbursement single evaluation and management (E/M) rates. Here’s a way for medical coders to see how much the new routes may affect your workplace’s reimbursement. This exercise will also help you determine what to share with CMS during the comment ...
In CMS
Jun 28th, 2018
In its 2018 Physician Fee Schedule Proposed Rule, the Centers for Medicare & Medicaid Services (CMS) suggested that it was open to the idea of revising the current (1995 and 1997) E/M Documentation Guidelines, and solicited comments from “a broad array of stakeholders, including patient advocates, on the specific changes we should undertake to reform ...
In Coding
Jun 7th, 2018
Each time you meet with a patient, you should document a chief complaint (CC). CPT defines the CC as “A concise statement describing the symptom, problem, condition, diagnosis, or other factor that is the reason for the encounter, usually stated in the patient’s words.” Simply stated, the chief complaint is a description of why the ...