Auditing Information

News and Important Information

AMA- Payor audits on the rise. How private practices can get ready. (part 1) 2022-04-2022
https://www.ama-assn.org/practice-management/private-practices/payor-audits-rise-how-private-practices-can-get-ready

Part 2 - https://www.youtube.com/watch?v=KKko2MsY4Cw&ab_channel=AmericanMedicalAssociation%28AMA%29

What is Medical Necessity and How Does Documentation Support It?

Auditing Looking Between the Lines

 

Resources

Select the title to see a summary and a link to the full article.  some articles require a subscription to view.

Jun 13th, 2019

What Medical Necessity Tools Does Find-A-Code Offer?

by  Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT

Find-A-Code is a great resource for individuals working in all aspects of healthcare, from providers and ancillary staff to the attorneys and payers who assess and critique the documentation supporting the services performed. When recently asked what tools Find-A-Code has to help support medical necessity, our response was, "We provide many resources ...
Apr 23rd, 2019

Let's Talk High Risk E/M Services

by  Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT

Have you ever assigned a high-complexity E/M code (e.g., 99205, 99215, 99223, 99233, 99245, etc.) and wondered if it would stand up to further scrutiny? Well, let’s take a closer look at the requirements for reporting high-level E/M services.   Both the American Medical Association and Medicare-published E/M Guidelines agree that a ...

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