Experience. Integrity. Advocacy.
Experience. Integrity. Advocacy.

Clinical Documentation

CMS Releases Critical Care CBRs for Second Year in a Row

The Centers for Medicare and Medicaid Services is once again releasing Comparative Billing Reports to some providers who perform critical care evaluation and management services. This time, they will be analyzing claims that occurred in part during the COVID-19 public health emergency, with dates of service from Jan. 1, 2020, through Dec. 31, 2020. READ MORE

Pre-Anesthesia Evaluation, Pre-Surgery History & Physical, and Separately Reported E/M Services: Know the Difference

While recent changes to office or other outpatient evaluation and management coding and billing guidelines may not affect anesthesiologists most of the time, there are instances when knowing the new rules will come in handy, especially with patients who have complex medical co-morbidities. READ MORE

Anthem to Implement Post-Pay Reviews for ED Level 5 Claims in Some States; Indiana Currently Excluded

Anthem Blue Cross and Blue Shield recently announced a new policy of post payment reviews of professional ER claims billed with level 5 E/M codes. The new policy is being implemented to “ensure documentation meets or exceeds the components necessary to support its billing,” according to Anthem, and will begin August 1. Indiana and a few other states currently are excluded. READ MORE

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