2025 Gastroenterology Reimbursement and Coding Update (Virtual) | November 2024-Auditing Docs and APPs within Your Practice

Video Transcription

Video Summary

The presentation offers practical advice for healthcare providers on coding, billing, and navigating payer audits. Emphasizing communication, it notes that medical professionals often lack comprehensive training in coding and billing, requiring education to avoid audits. Key points include familiarization with E&M codes and their relevance to audits, understanding national benchmarks, and adapting documentation to support billing levels. The presentation underscores the importance of meticulous documentation, especially concerning addendums and record modifications, to avoid falsification accusations. Additionally, it highlights various audit types such as OIG, RAC, and CERT, explaining their focus and best practices for managing audits. There's an emphasis on legal and thorough record-keeping, as well as understanding the intricacies of specific coding issues, like modifier usage. Providers are encouraged to consult healthcare attorneys if facing significant audits or investigations to ensure compliance and to safeguard their practice.

Asset Subtitle

Kristin Vaughn, CPC, QMC, QMGC, CPMA, ICDCT-CM

Keywords

healthcare coding

payer audits

E&M codes

documentation practices

audit management

healthcare compliance