Punch Biopsies

Mar 13, 2024 | Coding Quandry

Question: A patient came in for two punch biopsies due to dermatitis that wouldn’t clear after treatment for a few months.  The doctor thinks that he should be able to bill an E/M with the visit, but I say no.  Who is right?  Answer:  I don’t like giving this answer,...

The Stability Factor: Documenting Chronic Exacerbated Conditions

Feb 16, 2024 | Article

I have been in the healthcare field for more than 35 years, and remember when we didn’t have Evaluation and Management (E/M) codes. Then, we went through the 1995 and 1997 guidelines from CMS. All the elements, boxes, borders – UGH! Now, we have a cleaner way to...

The CERT Program

Jul 19, 2023 | Article

What It Is and What a Practice Needs to Know The Comprehensive Error Rate Testing (CERT) program is a crucial component of the Medicare program that helps ensure the government is paying only for the services and care that beneficiaries actually receive. The program...

Chronicity of the Condition

Feb 3, 2023 | Coding Quandry

Question: One point of clarification I’ve wondered about. What defines the chronicity of the condition? Is it if it’s lasted more than one year already for the patient or is it if we know that it’s going to last more than a year even if it’s...
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