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Cloned notes can lead to legal trouble – run audits, ‘use cases’ to minimize risk

08/16/2021

Question: We know that if we’re not careful our cloned notes can lead to inappropriate data in an encounter record, which in turn can lead to denials and takebacks. But can you be prosecuted for fraud because of cloned notes?

Don’t chain social determinants of health for MDM risk to ICD-10-CM codes

08/16/2021

by: Julia Kyles, CPC

Question: We are considering the following policy for E/M visits: Coders can’t select moderate risk because a social determinant of health (SDOH) affected the diagnosis or treatment, unless the note supports an SDOH diagnosis code from the Z55-Z65 range (Persons with potential health hazards related to socioeconomic and psychosocial circumstances). That way we can make sure the risk level is supported by the note.

Avoid routinely waiving patient copays; follow these tips instead

08/16/2021

by: Laura Evans, CPC

Question: The doctor asks to not charge a patient for any of their visits. The patient has Medicare. Is it legal to bill Medicare and write off the patient’s portion or to write off the entire charge and not bill Medicare at all?\

Proposed cuts to E/M office visits prove less harsh than other settings

08/16/2021

by: Roy Edroso

No matter the setting, you can expect a reduction in payment for a large swath of E/M codes in 2022, according to a Part B News analysis of payment adjustments mandated within the proposed 2022 Medicare physician fee schedule.

Delta dawn: Coping with COVID variant, rising infections may require a return to basics

08/09/2021

by: Roy Edroso

The emergence of the unpredictable Delta variant is fast becoming a stress test for your COVID preparedness. To get through the latest challenge, make sure you stay abreast of the current state of regulations and lean on your infection control protocols.

Which split/shared? CMS plan would create 3 similar, but not identical, policies

08/09/2021

by: Julia Kyles, CPC

Share this chart when staff want to compare the planned split/shared guidelines in the proposed 2022 Medicare physician fee schedule to the split/shared guidelines for office visits and each other.

Ensure edit clarity: Answering hot-topic NCCI and MUE questions

08/09/2021

by: Nicole Votta

Veteran coders and billing staff know that National Correct Coding Initiative (NCCI) edits and medically unlikely edits (MUE) can throw a wrench in the Medicare billing process, delaying appropriate revenue.

What to do when a consulting doc skips the interprofessional consult’s verbal report

08/09/2021

by: Julia Kyles, CPC

Question: We’ve been reporting the interprofessional consult codes (99446-99449). The descriptor for this code includes "a verbal and written report.”Our problem is that the doctor frequently forgets to perform the verbal report. Is there a way to report the consult at all?

How to accurately report multiday EEGs, with and without video

08/09/2021

by: Lori-Lynne A. Webb, CPC

Question: When might it be appropriate to report CPT codes for multiday electroencephalograms (EEG)? In addition, should these codes be billed on the day of initiating or ending the EEG study?

CY2022 fee winners paced by CCM codes; multiple procedures lose cash

08/09/2021

by: Richard Scott

Check the payment forecast for Medicare-covered codes: Despite a cut to the conversion factor, some services stand to garner significant pay increases in 2022. The biggest winner? That would be complex chronic care management (CCM) code 99489, on pace to rise 63%.

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