Separate Evaluation and Management (E/M) Services from the Rest When a provider performs an E/M service and other services including a procedure for the same patient, on the same day, you can code and bill for the procedure and the E/M service separately. You   Read more..

CMS Administrator Seema Verma recently announced a new initiative designed to improve EHR patient data access called MyHealthEData. Designed to improve EHR patient data access, MyHealthEData is a government-wide initiative led by the White House Office of American Innovation in conjunction with the Department of Health   Read more..

Like all CPT® codes, E/M codes are universal and used by Medicare, Medicaid, and most other payers for processing claims for a physician’s professional services. You should also use E/M service codes for billing facility services on an outpatient basis. Because evaluation and management services are   Read more..

Your reimbursement relies entirely on accurate reporting. Someone in your office must understand the code sets, coding guidelines, and the nuances of coding. Additionally, this person must possess the ability to communicate with physicians and other clinicians about how to document a service appropriately to   Read more..

Audit tools are essential to successfully completing an audit. Whether you utilize electronic tools or paper worksheets, you will need access to good auditing tools. Electronic audit tools are helpful because they not only assist with the process, but also aid in reporting. The pros   Read more..

New Medicare Card: Video for Your Waiting Room In April 2018, CMS will begin mailing new Medicare cards with new numbers—and they’re helping you inform your Medicare patients with the New Medicare Cards are coming! video. Play this one video, available from YouTube, in your waiting room. As   Read more..

New in 2018: QPP Year 2 Eligibility In QPP Year 2, eligible clinicians remain the same, and there is no change in Basic Exemption Criteria, but CMS reduces the number of providers and groups subject to the QPP by increasing the low-volume threshold. The CY 2018   Read more..

As is the case with patient’s history, payers and auditors use a similar logic for establishing medical necessity when scanning the PE records for over-documentation. Reviewers may identify elements of the PE that are not consistent with the CC and may determine that services were   Read more..

The EMR is a dynamic document database, evolving every time a user accesses it. With today’s standard features and add-on conveniences, EMRs have the potential to save time, increase productivity, enhance efficiency, and play an important part in patient engagement. However, it is imperative that   Read more..

Providers should not let the EMR code for them. If it does, the providers need to override the system and only use it as a guide. The EMR is not equipped to understand nuances of medical-decision making that only a provider could determine. Say yes   Read more..