Medical Coding Audits: Whenever you receive an “audit” email, do you feel a knot in your stomach? Fear not, fellow coder! Audits are an important part of maintaining secure, efficient, and well-documented code. They help identify areas for improvement and potential bugs before they cause major problems. It is the purpose of this newsletter to […]
Payers have been wrongly cutting payments to physicians for evaluation-and-management (E/M) services—often automatically through the use of claim-editing algorithms. A new AMA resource helps physicians fight back against health insurer downcoding. Downcoding happens when a payer changes a claim to a lower-cost service than what was submitted by the physician, leading the practice to get […]
Many of us have been immersed in COVID-19 and telehealth billing, coding, and the varying rules among payors of late, all the while the clock has remained ticking on the looming changes to evaluation and management (E&M) services, effective Jan. 1, 2021. It is possible, too, that there are those who have not heard of […]