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4 / 30 / 2020

Posted by: Zach Stephens – 5th Circuit Decision on Materiality

News you can use…. Fifth Circuit Affirms Dismissal of Qui Tam Complaint Due to Lack of Materiality in Significant False Claims Act Decision The U.S. Court of Appeals for the...
10 / 2 / 2019

Clarifying Screening vs. Diagnostic Testing

If you have questions regarding the difference between a screening and a diagnostic test and when to bill for them separately-You are not alone! Let’s start by going over...
9 / 3 / 2019

Assistant-at-Surgery Indicators

By
Jessica Sullivan
When reviewing surgeries in order to determine whether an assistant is billable, coders and their providers should always be aware of what is needed in terms of necessity and documentation....
2 / 18 / 2019

CMS 2019 E/M Changes: Reduce Burden and Excel in Patient Care

By
Alysia Delozier
Documentation requirements for physician Evaluation & Management (“E/M”) visits have not been updated in 20 years.  On November 1, 2018, CMS finalized bold proposals that address provider burnout and...
2 / 11 / 2019

Critical Care is Critical to the OIG: Know the Requirements

In 2019, Office of Inspector General (“OIG”) added the review of critical care evaluation and management codes to their work plan for the Office of Audit Services. This review...
2 / 6 / 2019

2019 CPT Changes-E/M Services

By
Alysia Delozier
The biggest change and most talked about topic so far with the new 2019 CPT changes is telehealth. Home services have also been expanding in the medical field and  what...
1 / 28 / 2019

Muscle Testing

By
Alysia Delozier
In this procedure, the provider performs manual muscle testing to determine the extent and degree of muscular weakness resulting from disease, injury, or disuse. A formal report must be...
1 / 28 / 2019

Heart Failure vs. Dysfunction

The most recent diagnostic trend among cardiologists is a “new” type of heart problem known as heart dysfunction. When heart dysfunction becomes severe, heart failure can occur. Heart failure...
1 / 28 / 2019

CMS Changes Coverage for ICDs

On February 2018 CMS released a Final Decision Memo making some “minimal” changes to the National Coverage Determination for ICD’s (20.4). CMS added magnetic resonance imaging (MRI) to the...
1 / 28 / 2019

Skin Biopsy vs. Shave

By
Alysia Delozier
Shave Removals and Excisions Shave removal of skin lesions (CPT codes 11300–11313) includes the removal of tangential or saucerized skin lesions to a level no deeper than the base...