Lara Smith
Modifier 59 is shockingly confusing for coders, auditors and physicians alike. It’s frequently misused, for example, it’s often added as prevention or recoupment of an insurance denial as a way to get additional procedures paid.
CJ Wolf
The New Year is right around the corner and most of us have a lot to do to prepare for next year.
CJ Wolf
Conducting effective internal investigations is an acquired skill; you’ve got to think like James Bond.
CJ Wolf
1. Influencer not Enforcer: How to Avoid the Dreaded Corporate Cop Image
When it comes to compliance, sometimes image is everything. How you’re perceived in your organization can either work for you or against you.
Stephani Scott
The Medicare Access and CHIP Reauthorization Act (MACRA)
The Medicare Access and CHIP Reauthorization Act (MACRA) of April 2015 will not only significantly change physician reimbursement, it will also change how we audit for correct coding and documentation.
CJ Wolf
The field of compliance isn’t as simple as hiring honest people who will hopefully “always obey the rules.” In fact, careful hiring doesn’t constitute a compliance plan at all.
Marina Gregory
“Time is on my side. Yes it is.” But knowing whether or not time is a factor to qualify for a particular level of E/M can lead to uncertainty. So when is time a factor?
Kristin Rodriguez
Everyone is talking (and panicking) about Hierarchical Condition Categories (HCCs) lately and for good reason: HCCs are progressively being applied to numerous healthcare reform initiatives and it’s pretty confusing.
