Search found 45 matches

by lori
Fri Mar 22, 2019 2:27 pm
Forum: Medical Auditing Forum
Topic: Consults/Initial Hospital Care
Replies: 0
Views: 3552

Consults/Initial Hospital Care

Hi. For original Medicare, I understand that the initial hospital care codes 99221-99223 should be applied for E/M services that would have been reported as consultations prior to the "big change" in 2010 when Medicare stopped recognizing the consult CPT codes. So when a specialist is asked by anoth...
by lori
Wed Aug 08, 2018 12:42 pm
Forum: Medical Auditing Forum
Topic: 8/7/18 NAMAS Webinar Q&A "Incident-To for Medicare"
Replies: 1
Views: 1523

Re: 8/7/18 NAMAS Webinar Q&A "Incident-To for Medicare"

Thank you for answering all the submitted questions and for posting this Q & A.
by lori
Mon Aug 06, 2018 5:21 pm
Forum: Medical Auditing Forum
Topic: Transitional Care Management
Replies: 1
Views: 1618

Transitional Care Management

Hi. Is Medical Decision Making scored any differently for Transitional Care Management than for any other E/M service? For example, CMS lists the items pasted below as provider non-face to face services that are "components" of the TCM. Does this mean that for TCM we should not score 2 points for re...
by lori
Wed May 16, 2018 10:08 am
Forum: Medical Compliance Forum
Topic: Definition of Medicare Overpayment
Replies: 0
Views: 7396

Definition of Medicare Overpayment

Hi. I've read Medicare's definition of an overpayment but am somewhat unclear on the application. If a provider has sufficient documentation to support that a service was rendered as billed but the documentation is missing an element required by the MAC, does this constitute an overpayment? For exam...
by lori
Tue Nov 28, 2017 2:16 pm
Forum: Weekly Tip Comments & Discussions
Topic: Conference Location
Replies: 0
Views: 7694

Conference Location

Hi. Will NAMAS please consider bringing the conference back to the Asheville area...or perhaps adding an additional conference each year in Tennessee or the Carolinas? Thank you for your consideration!
by lori
Fri Nov 10, 2017 3:28 pm
Forum: Medical Auditing Forum
Topic: Complete Stay Audits
Replies: 2
Views: 2266

Re: Complete Stay Audits

Thank you very much for that answer. The significance of those CPT narratives for 99231-99233 seems to be frequently misunderstood or ignored altogether. May I ask for your perspective on a related question? Hypothetical case: patient with cancer is admitted. On day 4 of the hospital stay, the treat...
by lori
Fri Nov 10, 2017 2:33 pm
Forum: Medical Auditing Forum
Topic: Medicare Annual Wellness Visits
Replies: 2
Views: 1752

Re: Medicare Annual Wellness Visits

Thank you for that info. We know CMS does make reference to the CDC publication you attached as an example of HRAs, but do you know why CMS still states in Chapter 15 of the Medicare Benefit Policy Manual that all of those specific detailed bullets are required? CMS seems to be contradicting themsel...
by lori
Fri Oct 20, 2017 1:09 pm
Forum: Medical Auditing Forum
Topic: Medicare Annual Wellness Visits
Replies: 2
Views: 1752

Medicare Annual Wellness Visits

Hi. My questions are related to the HRA portion of the Annual Wellness Visit. My first question is: does the HRA need to be separate and/or easily distinguishable from the rest of the AWV documentation? My next question is regarding the specific requirements for the HRA. The general info published b...
by lori
Mon Sep 18, 2017 10:06 am
Forum: Medical Auditing Forum
Topic: Decision Making - Additional Workup Planned
Replies: 2
Views: 1518

Re: Decision Making - Additional Workup Planned

Thank you for your input!
by lori
Thu Aug 31, 2017 2:56 pm
Forum: Medical Auditing Forum
Topic: Complete Stay Audits
Replies: 2
Views: 2266

Complete Stay Audits

Hi. I see there is an unanswered question posted on July 6 with this topic, and it prompted me to ask related questions as well. Previously for coding of physician E/Ms in the hospital, my understanding is that each hospital E/M by the physician is coded based solely on its own documentation. For ex...