Search found 53 matches

by Shannon DeConda
Tue Jan 09, 2018 11:10 am
Forum: Medical Auditing Forum
Topic: Psychiatric HPI
Replies: 1
Views: 706

Re: Psychiatric HPI

Associated S&S: Aggressive (While there is no CC specifically identified i think we could agree that he is agitated is at least somewhat of a chief complaint, and aggressive is a S&S of it) MF; Ativan There is no sated duration--- it seems implied it was within the past 24 hours, but because not imp...
by Shannon DeConda
Mon Apr 03, 2017 6:05 pm
Forum: Medical Auditing Forum
Topic: NGS Medicare Exam Changes
Replies: 6
Views: 2186

Re: NGS Medicare Exam Changes

i too think this is ludicrous. CMS in their own E&M Policy Manual regurgitate 1995 and 1997 Guidelines as their rules they follow which do NOT support a detailed exam documented in this way. I think this will continue to blur the lines of the already gray guidelines of E&M. At least Novitas states (...
by Shannon DeConda
Wed Dec 14, 2016 10:03 am
Forum: Conversations on Salary Survey, Job Duties, and Medical Auditing Positions
Topic: New to Auditing- Advice From NAMAS
Replies: 0
Views: 2590

New to Auditing- Advice From NAMAS

I am oftentimes asked the question, Ok, I did it! I passed an auditing certification exam, NOW... how do I get in the industry with no experience. I thought I would share my response that I recently shared with Carrie, new to the auditing industry: This is a common question that we are asked, but un...
by Shannon DeConda
Tue Jul 19, 2016 3:51 pm
Forum: Resources and Tools for the Auditor and Compliance Professionals
Topic: LINKS TO WHAT YOU NEED TO GET THE JOB DONE!
Replies: 0
Views: 3848

LINKS TO WHAT YOU NEED TO GET THE JOB DONE!

FEEL FREE TO ADD YOUR LINK REFERENCES AS WELL! 1995 Documentation Guidelines: https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0ahUKEwiY36fCpIDOAhXKQCYKHQ12Aj8QFggeMAA&url=https%3A%2F%2Fwww.cms.gov%2Foutreach-and-education%2Fmedicare-learning-network-mln%2Fmlnedweb...
by Shannon DeConda
Tue Jul 19, 2016 3:27 pm
Forum: Medical Auditing Forum
Topic: Chief Complaint
Replies: 4
Views: 2421

Re: Chief Complaint

Well actually here is the deal. This is a VERY good point we get in depth on during our E&M auditing bootcamps I teach. Refer to 1995/1997 DG and here is what it says: The CC is a concise statement describing the symptom, problem, condition, diagnosis, physician recommended return, or other factor t...
by Shannon DeConda
Tue Jul 19, 2016 3:20 pm
Forum: Medical Auditing Forum
Topic: NEURO/PSYCH EXAM
Replies: 1
Views: 2230

Re: NEURO/PSYCH EXAM

According to 1995 DG there is absolutely NO requirement on how much documentation is needed for each organ system. Normal is but one word and it can support the same organ system. Therefore, in light of "normal" supporting an organ system, why wouldn't "alert"? 1995 states that: Specific abnormal......
by Shannon DeConda
Tue Jul 19, 2016 3:11 pm
Forum: Medical Auditing Forum
Topic: MACRA MIPS and APM's
Replies: 1
Views: 2200

Re: MACRA MIPS and APM's

Great question- I think our job security will become even more validated as medical necessity will be even more critical. We recently conducted a FREE 30 minute webinar on this topic and have another upcoming 90 Minutes webinar on it as well. http://shop.namas.co/Live-Webinar-Event-MACRA-An-In-Depth...
by Shannon DeConda
Tue Jul 19, 2016 3:08 pm
Forum: Medical Auditing Forum
Topic: Catheterizations with major procedures
Replies: 1
Views: 2272

Re: Catheterizations with major procedures

Remember the rules of the 59 modifier- was the Foley done as part or for the same given reason/area. In your example, the answers seems to be yes and therefore the 59 modifier not supported. There is no flat yes/no answer for every occasion, but walking through the scenario and validating if the 59 ...
by Shannon DeConda
Tue Jul 19, 2016 3:00 pm
Forum: Medical Auditing Forum
Topic: status of chronic condtions - history
Replies: 1
Views: 2474

Re: status of chronic condtions - history

Great question- No. Guidelines indicate that the status of three chronic or inactive problems should be documented, but they do not include how much status is required. In my opinion, any amount of documentation that adequately communicates the status should be allowed. Therefore, Diabetes, stable t...
by Shannon DeConda
Tue Jul 19, 2016 2:56 pm
Forum: Medical Auditing Forum
Topic: Documenting Audit Process
Replies: 3
Views: 4116

Re: Documenting Audit Process

I am guessing that there have been no replies on this thread as many compliance departments, who are typically headed by attorneys, do not permit the sharing of these sensitive documents. I do understand what you are requesting, and Sean Weiss with our company does a lot of consulting for our client...