Jan 1st, 2015
Navigate complex state rules and comply with payers’ coverage guidelines and bylaws. By Joette Derricks, MPA, CMPE, CPC, CHC, CSSGB In 2013, the American Medical Association (AMA) established a definition for a qualified healthcare professional (QHP), in terms of which providers may report medical services: “A ‘physician or other qualified health care professional’ is an ...
In Audit
May 19th, 2014
Medicare allows coverage for services provided by Non Physician Practitioners (NPP’s) such as Nurse Practitioners (NPs) and Physician Assistants (PAs), per the following key principles. Qualifications To furnish covered services to a Medicare program beneficiary, Medicare requires that NPs: Be a registered professional nurse authorized by the State in which services are furnished to practice ...
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 ...
Sep 1st, 2012
By G.J. Verhovshek, MA, CPC A letter to the editor in the July 2012 Coding Edge, (“New vs. Established Patient Rule Applies to Physicians Only,” page 10) asked how the “new vs. established patient” rule applies to visits by nurse practitioners (NP). In response, Coding Edge editors—specifically, this editor—responded that an NP technically would not ...