Search found 18 matches

by jeskla
Tue Sep 21, 2021 2:02 pm
Forum: Medical Auditing Forum
Topic: NAMAS Webinar Q&A: Hands-on Examples of 2021 E&M Auditing, 08/24/2021
Replies: 1
Views: 1585

Re: NAMAS Webinar Q&A: Hands-on Examples of 2021 E&M Auditing, 08/24/2021

Question 11: When giving data credit for independent interpretation, does that only get counted if the radiologist interp is not ready when the physician interprets the image? Answer 11: Only one provider can get credit for the interpretation. Would like to open a discussion about this answer. The ...
by jeskla
Thu Sep 16, 2021 10:47 am
Forum: Medical Auditing Forum
Topic: How many vitals are required for the credit?
Replies: 1
Views: 4456

Re: How many vitals are required for the credit?

I recently saw something stating, that for 1995 exam guidelines, only one vital (one of the 7-sitting or standing blood pressure, supine blood pressure, pulse rate and regularity, respiration, temperature, height, and weight) need be documented for the "bullet". I always thought 3 were required reg...
by jeskla
Fri Sep 10, 2021 12:34 am
Forum: 2021 E/M Changes Challenge Forum
Topic: 2021 E/M Data Scoring
Replies: 1
Views: 12860

Re: 2021 E/M Data Scoring

It is my understanding that if the same cardiologist performs the interpretation/report and bills separately for that echo on that date or a future date then they can’t get the data point for ordering it even though the echo may or may not be done on the date of the E/M. However, if the echo interpr...
by jeskla
Wed May 26, 2021 1:45 pm
Forum: Medical Auditing Forum
Topic: NAMAS Webinar Q&A: Office vs. Inpatient E&M in 2021
Replies: 1
Views: 7542

Re: NAMAS Webinar Q&A: Office vs. Inpatient E&M in 2021

Could you please elaborate on the last question of the CEU quiz? I believe the question was something like this: Patient presents with COPD exacerbation. Nebulizer treatments are given and the patient is improved. A prescription for prednisone is given. The question was what is the MDM level and the...
by jeskla
Tue Mar 30, 2021 7:15 pm
Forum: 2021 E/M Changes Challenge Forum
Topic: Minimal Vs. Low risk of morbidity
Replies: 3
Views: 6484

Re: Minimal Vs. Low risk of morbidity

This issue is frustrating for me as well. We are getting hit heavily with UHC audits on 2021 DOS already. We've been using the AAPC calculator. Their section for risk includes things that aligned with the old risk table: otc meds, physical therapy as low. Yet, UHC is denying our level 3's stating, t...
by jeskla
Tue Dec 29, 2020 10:12 am
Forum: 2021 E/M Changes Challenge Forum
Topic: CHALLENGE #32 — It's YOUR Turn!
Replies: 7
Views: 9748

Re: CHALLENGE #32 — It's YOUR Turn!

Do you disagree with the risk on the 2021 AAPC coding calculator? https://www.aapc.com/codes/em-calculator-2021/index It uses the examples in our current risk table. Minimal Chest x-rays EKG/EEG Urinalysis Ultrasound, e.g., echo KOH prep Rest Gargles Elastic bandages Superficial dressings Physiologi...
by jeskla
Tue Dec 22, 2020 9:34 pm
Forum: 2021 E/M Changes Challenge Forum
Topic: different specialty same tax id
Replies: 1
Views: 5849

Re: different specialty same tax id

Yes, I believe so. Per the MDM table : Data Category 3: Discussion of management or test interpretation • Discussion of management or test interpretation with external physician/other qualified health care professional/appropriate source (not separately reported) https://www.ama-assn.org/system/file...
by jeskla
Mon Dec 21, 2020 12:09 pm
Forum: 2021 E/M Changes Challenge Forum
Topic: CHALLENGE #32 — It's YOUR Turn!
Replies: 7
Views: 9748

Re: CHALLENGE #32 — It's YOUR Turn!

Please clarify the differences in answers regarding risk. In example #28 the risk answer is low for "the ear drops were discontinued." In example #5 the risk answer is minimal. "ice, elevate Motrin". Assuming the ear drops were over the counter instead of prescription, I don't understand why they bo...
by jeskla
Mon Dec 21, 2020 11:54 am
Forum: 2021 E/M Changes Challenge Forum
Topic: CHALLENGE #32 — It's YOUR Turn!
Replies: 7
Views: 9748

Re: CHALLENGE #32 — It's YOUR Turn!

Would I give credit for independent interpretation for both the scenarios below if our office ordered the MRI: 1. The patient had their MRI done 6 months ago by an external source and the physician brought up those images on the screen and states: Data: MRI of the lumbar spine was again brought up o...
by jeskla
Mon Dec 21, 2020 11:18 am
Forum: Medical Auditing Forum
Topic: Repeat test on separate DOS
Replies: 1
Views: 7781

Re: Repeat test on separate DOS

For medical necessity, the CDC seems to leave the medical necessity to the physician to determine for repeat testing. Even though it's a scheduling issue, does the fact remain the physician thinks the patient should be retested prior to admission/procedure? Perhaps you could just reference : https:/...