Jennifer McNamara

Protect your practice with External Audits

Medical coding audits are an essential part of the healthcare industry, as they help to ensure that organizations are accurately coding their services. There are numerous benefits to conducting external medical coding audits including ensuring that medical providers are compliant with coding regulations. The goal is to identify any errors and to help medical practices …

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Unpacking the Global Package

Does the Global Package need unpacking? In order to answer this question, it’s important look at the value (RVU or Relative Value Unit) attached to certain procedures. The Global Package has applied to over 4,000 physician services since 1992. Over time, providers have been concerned about the valuation of many of these services. Inflation and improvements to certain procedures …

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Complexity of Documentation and Data

In 2021, when the Evaluation and Management guidelines were revised, the area with the most confusion was ultimately the amount and/or complexity of data to be reviewed and/or analyzed. Like with other components, misunderstandings with definitions and descriptions were at the root of the problem. It is extremely important to read the full description and …

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Hernia Coding Simplified in 2023

In September 2022 the American Medical Association announced the new codes for 2023. Of note for General Surgery practices was a complete overhaul for Hernia codes. There are 15 new CPT codes (49591-49623) that will replace the existing codes which combines location, approach and specifies the size of the repair. For instance CPT code descriptions …

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Radiation Oncology Audit Insights

Are you struggling with your Evaluation and Management reimbursement for Radiation Oncology services? Radiation Oncology has nuances, and you may be leaving money on the table without a good understanding of how the 2021 Evaluation and Management guidelines impact Oncology services.

When capturing Evaluation and Management services, the goal is to capture the true data behind the risk and problems addressed to report the service accurately. Beyond the reimbursement, what else does the accuracy of code capture do?

Opthalmology Evaluation under the Microscope

In 2004 I took on my second specialty in Healthcare in the world of Opthalmology. I was introduced to the specialized procedures and services performed by professionals in this space. Over the next few years I dug into this specialty learning the Anatomy, Disease Process and importance of eye health. Years of Audits led me …

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