The below articles are all published in BC advantage
Magazine and written and contributed by Shannon O.
Deconda, CPC, CPC-I, CEMC, CMSCS, CPMA, CMPM, CPMN
Shannon O. Deconda, CPC, CPC-I, CEMC, CMSCS, CPMA, CMPM, CPMN Director of Coding and Reimbursement
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Problems Addressed Regardless of the Place or Type of Service
I can't remember if I've recently covered this topic, so one of us (or maybe both of us) may have deja vu today. We're still getting inundated with questions about Problems Addressed regardless of the place or type of service, so whether I've already...
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Concurrent Critical Care
A great deal of time was spent this year with new coding updates focusing on critical care split shared updates, but not much time was given to all of the other red-lined updates in the critical care section of the CMS Claims Processing Manual. ...
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Should Your 2022 Audit Plan Include Paid Claims?
In 2022, when we sit down to configure an audit plan, we often consider whether we will perform an audit retrospectively or prospectively, and whether the sample will include evaluation and management (E&M) services, procedures, or some combinati...
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Chief Complaint
What do you do when you come across an E&M encounter that has no chief complaint
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What to Expect From an Audit Report
Spending compliance dollars to conduct a third party proactive coding and documentation audit is a large investment for any practice
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ICD-10: 8 Days and Counting!
The last full week of ICD-10 preparation is here. Hopefully, you have the proper tools in place and the education your team needs to have success, but don't stop preparing now that we are in the home stretch.
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Time-Based Services
How many of you have been under the impression that if time is used as the controlling factor in E/M code assignment...
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This weeks tip: Modifier 24
The 24 modifier is appended to indicate that a service other than treating and/or following up on the patient was performed during the global period.
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Have You Heard of H.R. 2652?
As you read this story it is important to understand the content contained within is only Proposed Legislation, and does not mean you can abandon your current obligation for meeting the October 1, 2015 implementation date for ICD-10.
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Internal Audits for the Physician Practice
Audit- a big buzz word in healthcare these days, but many practices that fall in the small to mid-size range fail to see the importance and relevance of proactive internal reviews.
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Sign Here
How simple it seems that all medical records must be signed by the provider, but the surprising reality we find in the world of auditing is how many records are lacking a signature. CMS has specific rules about signatures. Take a moment to answer t...
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When Is a Decision Reimbursable?
Many commercial carriers have providers in an uproar regarding the carrier's interpretation of the global surgical package. Here is the scenario:
Patient presents to the Emergency Room for evaluation, and after evaluating the patient, the ER provide...
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Validation of a Providers Right to Bill
By: Shannon DeConda, CPC-I, CEMC, CMSCS, CPMA How deep does your typical audit go? If you are acting as a third party auditor/consultant and are performing a Compliance Audit for a client, is the coding and documentation all you are reviewing? O...
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Provider Enrollment - Conquering the Pitfalls!
Provider enrollment is one of the most exasperating trials of a physician or non-physician provider's career. In our emerging paperless society, credentialing is a very paper labored process. Not only are the applications and contracts long and ted...
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