Posted and filed under Events, FWA, Medical Record Auditing.

ICYMI: 2018 OIG Work Plan Webinar

Advize Health’s first webinar of the new year will be broadcasting live today from 2:00PM EST until 3:30pm EST. The program will break down the 2018 OIG Work Plan and provide an in-depth examination at the OIG (Office of Inspector General) and their efforts in the fight against fraud. From mandatory requirements, to laws and…

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Posted and filed under Compliance, Fraud, FWA, Healthcare, Medical Record Auditing.

Risky Retrievals

For years, whenever we began launching a medical record review project, clients and physicians alike would ask us the same question: Why can’t you come onsite to pick up the requested records? The easy answer would have been to say that we simply hadn’t performed record retrievals before, but we had vested interest in doing…

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Posted and filed under Coding, Medical Record Auditing, Payers.

Mammography Coding

In honor of Breast Cancer Awareness Month, we’ve decided to release a brief reminder to not only schedule a routine mammogram, but to recall the 2017 Mammogram Coding Changes. Mammography Coding The Centers for Medicare and Medicaid Services (CMS) announced in November 2016’s final rule that they would not be able to accommodate the new…

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Posted and filed under Coding, Medical Record Auditing.

2017 UDT Codes Refresher

As of January 1, 2017, providers who administer controlled substance testing should apply the proper and most current guidelines for L35724 – Controlled Substance Monitoring and Drugs of Abuse. Best Practices Ensure that services and procedures reported on submitted claims match the service(s) ordered by the physician. Remember that a maximum of one presumptive and…

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Posted and filed under Compliance, Medical Record Auditing.

Sign, Seal, Deliver: Provider Signature Requirements

To a physician, providing authentication may appear as yet another inconvenience or hindrance to productivity in the midst of the already chaotic audit process – but it’s the difference between being reimbursed and having your claims denied. For the purpose of a medical record audit, Medicare requires that any services provided be authenticated within the…

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Posted and filed under Coding, Medical Record Auditing, Payers.

Think Twice Before Appending Modifiers

Coding Modifiers In the English language, a modifier is used to describe the who, what, how, why, and/or where of a situation. Coding modifiers perform the same role for medical coders and billers. These types of modifiers further describe procedure codes without altering its original definition. Modifiers can be found in both the CPT and…

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Posted and filed under Compliance, Medical Record Auditing.

Surviving the Medical Record Retrieval Process

Tackling a project as intricate as Medical Record Retrievals may seem daunting – and it is, but you can still make it through unscathed. Perhaps your firm was enlisted by an attorney, health plan, or medical auditing organization to retrieve medical records directly from a provider’s office. What tools do you need? How do you…

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Posted and filed under FWA, Medical Record Auditing.

How to Deliver Quality Litigation Support Services

If you were an attendee at last month’s webinar on arbitration and litigation support for medical coders and auditors, you’re aware of the fact that legal support is a growing need in the healthcare industry. It may come as no surprise given the alarming numbers associated with Medicare fraud in the United States, that more…

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Posted and filed under Coding, Medical Record Auditing.

Keep M.E.A.T. on Your List for a Healthy Audit

If you’re reading this article, chances are you already know what HCC Coding is – but we’ll give you a refresher anyway. Hierarchical Condition Category (HCC) and Risk Adjustment Coding is a CMS-mandated payment model. This particular model works to identify those with chronic and other serious illnesses and prescribes a risk factor score to…

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Posted and filed under Coding, Medical Record Auditing.

Overview of Colonoscopy Coding

Diagnostic Colonoscopy A diagnostic colonoscopy is a test performed as a result of an abnormal finding, sign, or symptom (such as diarrhea, abdominal pain, etc.). Factors for Consideration: Symptoms before the procedure such as a change in bowel habits, rectal bleeding, etc. Findings during the procedure (polyp, cancer, diverticulosis, etc.) Personal history of cancer or…

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