Measure Your HIPAA Data Compliance Against This Checklist

Find out whether you’re doing all you must to avoid costly violations. You’ve probably noticed plenty of websites asking you to accept “cookies” or rejoin email lists this summer. That’s because the EU’s General Data Protection Regulation (GDPR) took effect May 25. Designed to give European citizens more say over how their personal information is … Read more

Are You Documenting and Coding Chronic Conditions the Best Way?

Exercise this option to support higher CPT® codes when needed. In their paper arguing for longer “routine” primary care visits, Dr. Mark Linzer and colleagues describe “[a] 78-year-old widow with hypertension, osteoarthritis, a recent stroke, elevated cholesterol, and a 50-pack-year smoking history [who] comes to her primary care provider for a mild cough and weight … Read more

Avoid These Common Problems Revealed by Medical Coding Audits

Keep these perennial pitfalls in mind for your internal auditing. The AAFP tells healthcare organizations keeping their error rate (the percentage of claims payers deny) below 5% is “desirable.” Hitting that target is hard. One consultant and auditor, Jacqueline Thelian, told For the Record she’d seen “maybe five clients” reach 95% accuracy in 27 years. … Read more

How to Get Better Documentation for Improved Health Risk Appraisals

Discover two coders’ keys for getting better information from doctors. What advice would you give the medical coder who asks, “My doctor only wants to list the primary diagnosis. How can I convince her to document the significant comorbidities?” It’s a common problem. When physicians perform health risk assessments of Medicare beneficiaries, comorbidities and other … Read more

How Can You Help Your Physicians Learn Medical Coding?

Discover How to Avoid Frustration Coders and Physicians Face If you’re a medical coder or coding administrator feeling frustrated by “incomplete and nonspecific” documentation… Or fed up with patient charts “replete with errors and discrepancies”… Or you despair of bridging a “communication divide” between coders and physicians… …you’re not alone! These frank descriptions come from … Read more

Understanding How MACRA and MIPS Make Documentation Matter Even More

Discover why your success in this QPP track depends on documenting. You probably don’t need to be told Medicare physician reimbursement is currently seeing, as Modern Healthcare put it, “its biggest change since its launch in 1965.” To avoid financial penalty, approximately 622,000 U.S. clinicians (as estimated in CMS’ final rule about the program) must … Read more

How to Make Sure Your Practice Achieves Telemedicine Compliance

Telehealth is on the rise. Here’s what you need to know to keep pace. It seemed like science fiction not long ago, but telemedicine (or telehealth)—real-time, two-way communication between physicians and distant patients—is poised to reshape U.S. healthcare delivery, especially in rural and other underserved areas. Granted, according to a 2017 study, 82% of consumers … Read more

Two “Do’s”, Two “Don’ts” for Handling a Medical Coding Audit

Find out four pointers for making it through your medical audit successfully. The most recent GAO report concerning money the U.S. government improperly paid,  estimates Medicare Fee-for-Service spent about $36 million it shouldn’t have in FY 2017. While that figure represents a 2.5% decrease—the lowest rate since 2013, in fact—it’s still an awful lot of … Read more

Could You Be Billing CPT Code 99205 More Often?

2021 ICD-10-CM

Make Sure You’re Not Missing Legitimate Revenue from New Patient Visits What CPT® evaluation and management (E/M) code would you assign this fictional patient office visit (adapted from one discussed in an MDCodePro video lecture)? A former patient you last saw four years ago limps into your office, complaining of severe pain in his left … Read more