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Category Archives: coders

What you don’t know CAN hurt you… so don’t shoot the messenger.


In seafaring days before the puzzle of calculating accurate longitudes was solved by the accuracy of John Harrison’s chronograph in the 18th Century, as author Dana Sobel puts it in her book entitled Longitude, “every great captain in the Age of Exploration became lost at sea despite the best available charts and compasses.” In fact, […]

E&M Code Justification: Fraudulent vs. Compliance Correct Methodology


After my audio program last week, there is always a persistent question: “If I choose a code first before I document, coudn’t that be dangerous?”
Well, it’s a polite question that is really saying…”Isn’t this fraud?”
It’s not, and here’s why.
The three key components of an E/M code are:

Medical Decision Making, (MDM)

Two out of the three key […]

The Tyranny of Electronic Medical Records


The EMR movement has been touted to promote savings in healthcare dollars by eliminating redundant care with access to records, a way to compare performance of healthcare by standardization and uniformity, and with a seamless network to share data nationwide, despite ongoing concerns about privacy and who will have access  (authorized and unauthorized), and for […]

LIVE AUDIO CONFERENCE: Risk Based Coding TM July 11


I’ll be giving a live audio conference on July 11, 2007 on my Risk Based Coding TM algorithm with Oakstone Publishing. Because I’m traveling to speak in California and later in Ohio, I’ll actually be in a hotel room in San Diego. So if you’d rather SEE and HEAR it live, shoot me an email […]

Easy for you to say… Language of Healthcare Misnomers


There are different “languages of healthcare.” Clinicians speak patient language but often don’t speak the healthcare language of regulation, quality, or finance. It pays to understand and effectively translate from one dialect to another. For instance, “medical necessity” may sound “clinical” but it’s really financial. For CMS, “medical necessity” doesn’t mean something that’s “medically necessary,” […]