Auditing Antics: CMS E/M Updates September 2025 Explained #medicalcoding #medicalcoder
[Music] Hello and welcome to the Auditing Antics podcast. So, we’ve had a lot of talk really going back and forth on social media or more specifically LinkedIn about the new updates that were put out by the CMS MLN for ENM services. Now, you know, one of the things that is really important that we look out for on a regular basis is making sure that we are paying attention to when new information is coming out, but then also what has changed. And you know, Michelle, I know you and I talked a little bit about as well, the fact that when these come out, sometimes you reread what’s always been there and you look at it through a different lens as well. Yeah, for for sure. That’s uh that is for sure. I do think that they really beefed this MLN booklet up um especially in relation to getting more specific um with the ENM services. So, while not everything is in red, um I do think that they’ve added a lot that um that was not there before and it’s kind of made it into a little bit better of a guide for the ENM services. Yeah, definitely. And I did notice, you know, a lot of things that I try to verbally reiterate during different audit feedback sessions, things like that, are now more so highlighted as, okay, this is what needs to be done. So, from that education standpoint, I like that we have that additional backing. Now, go ahead. It’s nice to have that official resource. Where is it in writing? Show it to us in writing. I try to say it so sarcastically because I often want to see where you know people’s thoughts and instructions are coming from in writing as well but I am a very much so black and white person so I always appreciate these types of things. Yeah. Yeah definitely. Now one of the first areas that I wanted to tackle today was the G2211. And you know, this is something that has been pretty painful, I know, for a lot of us because when it started, we pretty much were seeing it on every claim for some practices, some particular practitioners. And you know, it’s always been this unknown of how is this something that is going to be supported or reflected long term when we have different directives that say, “Oh, you don’t have to document specifically for the G2211, but yet you’ve got to have it supported from, you know, a medical necessity standpoint, a longevity of care standpoint, and it just makes it really difficult.” Um, for me, I was really happy when we got the additional FAQs out on it, but still didn’t go quite as as far as we wanted to see that go. So, Michelle, what was some of the standout for you with the G2211? Was there anything that you thought really reiterated what you try to report in your audit findings and things like that? So, I think one thing for me, and it’s always been there, is where it says um it’s on page five, and it says under the HixPix add-on code bullet number two, your visit is giving ongoing care for a single serious condition or complex condition like cickle cell disease or HIV. Now, obviously, those are just examples, but where I find this to be very important is when providers are documenting an acute visit, for example, and they’re seeing the patient for a sore throat, cough, they run those tests, uh they determine either something’s positive or something’s negative. They either prescribe a medication or give them treatment for symptoms. But never in their note do they document how they how this particular visit is contributing to the ongoing care of the patient for that for that single serious or complex visit. And um I think oftent times that’s kind of what’s overlooked because they’re like well they’re their primary care physician. you could see that they see them and that they’re involved in the ongoing care. But I think the key is how does this visit impact that long-term care relationship with the patient? And that’s what you want the documentation to show. It’s not just that. And I’m sorry, I see the macro statement all the time. This this I have a longitudinal care relationship. I think I said that wrong. No, you I think it was right. But I I don’t like that word. I know what you mean. But you But you know what? Longitudinal. Come on. Can’t we use normal words? But do do you see that macro statement as well? And I think they think that’s like this umbrella to cover their behind that CYA to be able to report this. And in all actuality, it’s their documentation that has to support that. you have to show through the work you’re doing how this impacts your long-term care. And I do think it’s completely possible um when these patients, you know, you are seeing them for multiple chronic conditions. Don’t forget to document that whole picture. I’m sure you took the patients diabetes into effect or even something like hypertension and things like that when you’re treating them for their acute illness. So don’t forget to include those in your documentation. Yeah. And you know, one thing that stands out to me when they give and like you said, this is a part of what was here before, but I think it’s important to reiterate this when we talk about certain code sets or certain codes. Um, previously they also gave us examples of what does support billing the G2211. And you know, it’s kind of frustrating to me because it says, okay, well, the medical record and the claims history should support it. But then they go on to say diagnosises, the practitioner’s assessment and plan for that visit. So that’s where we have that tie that you, Michelle, are referring to here where we need to see the relation. And it wouldn’t be enough for you know if if we think about the fact they give directives on just diagnosis we got to dig a little deeper because AMA says we cannot count something as a problem addressed if it is not taken into consideration and seen in that documentation which then impacts the level of service. So no just the do just the diagnosis alone is not enough. Then we got to figure in things like risk adjustment and things like that that tend to happen in the background. And same thing, it’s not enough that the patient just has it. You need to show how it’s impacting the overall care or complicating the overall care. So, you know, I know there is there’s like 5050 opinions on this in the industry where some people are like, they clearly say no documentation’s needed. But if we think about what could potentially need to be defended, it’s going to be a lot harder if we just have this random macro statement that is the same for every patient regardless of their situation without ever showing how that patient’s more complicated and, you know, all of those types of things. Now, um, one of the main clarifications here in the September updates for G2211 is that they talk about when you can report that with the modifier 25. So, this is actually something we had directives on starting January 1st of 2025, but they didn’t put it in here for clarification until September. So, pretty late there, but we got it at least. Um, so they’re stating here that when you report your outpatient or clinic, you know, outpatient or clinic um, services 99202 to 5, 99211 to 215 with the modifier 25, you can report that now the same day as an AWV, vaccine administration, any part B preventative service, including the initial IPE, if it’s furnished, in that outpatient setting. So, that is different because, you know, before they said no modifier 25 at all with this G-code, it’s going to result in that rejection. But now they’re saying, okay, in these certain circumstances, you could apply the 25 to the ENM and we would accept that as you know, adding in that G2211. And one thing that I will say because I did come across this, if this is something that you have automated to report through your EHR, you need to be double-checking those claims because I uh was working on a project where it was being automated uh through the through the system based on you know different elements within the documentation and all of a sudden all these G20 2211s is coming through with the 25 modifier. So with these caveats put into place, you can’t necessarily automate this anymore. Um but if you are automating the G2211, make sure that you are looking at the claims to ensure that it is being reported correctly. And remember too, this can have a large impact depending on specialty. We obviously see it a lot in family practice, internal med, but we now have a lot of surgeons, specialists that are wanting to report this, a lot of pediatricians where yes, there can be underlying conditions, but usually it’s typically one uh maybe two. It’s nothing like we would see in internal medicine typically. So, you know, keep all of these things in mind and it should never ever be automated across the board. Definitely not. And you know, you mentioned the specialties um that that continuing focal point for all needed services is extremely important. Really think about if your specialty provides that. And I can think of some that do not. Yeah. you know, you go see them for that very specific condition or or thing and they aren’t necessarily going to be looking at your whole or providing you care for all of your needed services. So, really think about that um for the specialties before you’re reporting. Yeah. If it’s more of a short-term thing that’s happening and you know they’re done, very little followup, little to no followup, one-time consult, things like that, it’s definitely not applicable. A lot of times you see follow-up PRN, it’s like, oh, so how is this a longitudinal relationship if they just need to come see you as needed? Yeah, exactly. Exactly. It contradicts right in that note. And even if that’s not like what you mean long term, you better believe that’s how it’s going to be interpreted on an audit. So be careful with that. Now Michelle, one area I think that’s, you know, for me anyways, one of the biggest areas of not really an update, but clarification is related to the ENM on the same day as a a procedure. Basically, I was going to say as a visit, but that makes no sense. The same day as a procedure. And you know, I actually had the day before I saw this update, I was meeting with opthalmology and we were talking about these eye injections. And you know, we had a pretty long conversation about what that looks like because, you know, one of the hardest things to really understand and navigate and explain is when we have procedures that have a zero day global period, right? Because a lot of people are saying, well, there’s no global period. There’s nothing else included in that, which is not the case. So, do you want to start go ahead and jump in and start to break down some the different areas that were standing out to you in this section? Yeah. So, one thing that I want to say before jumping into this is just because this is under the heading of intravitrial eye injections doesn’t mean that it doesn’t apply all over. And I think that’s something that as you know people in the compliance industry are trying to teach this concept of the 25 modifier and things still use this as a resource because they are referencing the um NCCI policy manual that’s not just specific to the eye injections. um they you know so just because this is under the heading they’re using very general terms with within here that would apply across the board. Um so the the first thing that um you know stands out and like you said this has always been there but I don’t recall it being to this level of detail in here prior. um but to me was include the decision to perform a minor surgical procedure in the payment for the minor minor surgical procedure and do not report it separately as an ENM service. And I think this is something that is um a good conversation to have. So, I think that some people um are under the impression that if the documentation clearly shows that they’re deciding today after they saw the patient to perform this procedure that supports the 25 modifier and it does not whether they are a new or established patient this applies. So, I think that’s a another issue as well that people are thinking, well, this is a new patient. They’ve never seen them before. Of course, we can bill an ENM and that is not the case as well. Um, and Michelle, real quick on the new patient situation. So, you had mentioned the reference to NCCI. A lot of times what I find working with clients is that 25’s just used across the board on everything. But if you actually go into a CCI edit checker tool or however you look that up, you will find that the majority of procedures actually do not technically bundle into a new patient ENM, which means the 25 is not required. But in this clarification, they clearly tell us that having a separately identifiable ENM service, even with a new patient, has to follow the same rules. And that particular bullet point is not even stating to add the 25. It’s just saying if you’re performing a minor procedure with a new patient, you still have to follow these rules for ENM services. And it’s something that we’ve known, but like you were saying, we haven’t always had it this clearly documented for us in guidance. Yeah. And Stephanie, I would you take a minute and um kind of explain the difference between discussing treatment options and working on developing a treatment plan versus just the decision to perform the procedure. Um because I think that’s also something that can be confusing and oftentimes misinterpreted as well. Yep. So couple of things when you’re working through this situation, you’ve got to first understand the scenario. Then we talk about documentation. So sometimes you may have to sit down with whoever it is that you are reviewing their notes and go back and say, okay, what are these visits typically like? So in this situation, I always like to use MO surgery as an example because a lot of time when I work with dermatologists and they perform MO surgery, I will know already if I look even at their billing data, I will know we’ve got a problem with medical necessity if I see them billing new patient visits with MO surgery. Why? Well, the reason for that is when you think about the clinical workflow and the clinical steps of a patient presenting for that procedure, they already know at that point it is malignant. So, it’s not a situation where they’re coming into derm with a new complaint. It’s unknown. Maybe they do or don’t have a past history. They’re talking about potential outcomes, potential prognosis, treatment options, all of those things. then they decide to move forward with a biopsy and see what the results are from there. That’s a very different situation than a patient having a confirmed malignancy being referred to a MO surgeon specifically for that procedure. So that scenario typically with Moe’s surgery unless something is new or has come up we don’t have that ability to bill for the separate ENM service because it’s known when they’re presenting they’re scheduled for it as a patient. Now when we think about that difference that you were talking about with really that fine line between okay yes we’re doing procedure or you know what are what are we going to discuss and build here from a treatment plan perspective and I will say a lot of times even if the scenario supports it we don’t always have it in documentation so we have to make sure we understand scenario first then we talk to our physicians and a about documentation. Now, with that being said, one of the key red flags that I see when we don’t have medical necessity, even if it’s the same day that it’s decided on, it wasn’t pres-scheduled, predetermined, is if I go into the treatment plan and all I see is the performance of the procedure, that tells me absolutely nothing about what it was that was found on examination. Remember the treating practitioner’s perspective is what is intended to be the assessment not just a diagnosis. So what are they thinking? What are their concerns? What differential diagnosises if it has to be some kind of diagnostic type procedure. So you know all of these things tend to be left out and really they need to be captured in free texted documentation. Now, another thing I find that’s something I was gonna comment on is how many times do we see this canned statement about the treatment options were discussed and the patient has elected to proceed with XYZ. Well, I mean what what treat what were the treatment options? So, I think calling out the need for free texted documentation, you’re not going to cover this with a macro statement. um as as far as and I think that’s something that even I in the past have have misconstrued about the 25 modifier because I think it’s this is a topic that can be so so confusing and it is very subjective. There are lots of different opinions, but um I think for me that that statement about the decision to perform this the procedure alone does not support the ENM that that you know kind of is a let that be a light bulb moment. Yeah. you know, for you and and really is what else was documented the the true process of developing a treatment plan or was it just a canned statement to say you’re going to do this procedure today? Yeah, I I like to and this may help. So I like to put the decision for procedure in the same bucket we put in that discussion about risks and benefits and all of that with the patient right that’s something that happens across the board with every patient having that particular procedure so apart from that what else is going on and you know to your point Michelle about the macro statement I am dealing with so many upic audits right now and investigations right now and you know some of them the recoup amounts. You know, some we’ve got as low as close to 9,000. Today, I’m going through one that’s close to a million in recoupment. So, you know, one of the the trends that I’m seeing in the auditor’s feedback in these upup findings is that they’re constantly referencing the overuse of a macro where it’s not personalized to the patient. So if everything says and I’ve seen that exact statement that you referred to there. If everything’s saying that about a procedure that or about every patient who receives the same procedure, we still don’t see that individual component. And remember this doesn’t mean that you couldn’t defend it afterwards. But these are directly reflecting 100% denial rate that I’m seeing come back on a lot of these upup reviews. So, we’ve got to be careful about the detail that’s going in there. And one other component, Michelle, a lot of people misunderstand is when they talk about care of the procedure site. So, for example, let’s say a patient has a joint injection done and they’re given instructions to use over-the-counter pain medication if they have pain at the site of injection or maybe hot and cold packs, whatever it may be. I see a lot of people, you know, on a rebuttal say, “Well, they got over-the-counter medication that’s low risk.” No, that is directives that are given based on the treatment site and location. That is not separate treatment decisions being made apart from the performance of that procedure. So, you know, again, can statements really don’t work 100% across the board. You’ve got to make sure we’ve got enough information in there. Exactly. And um oftentimes that’s that’s what’s missing. So kind of with our conversation last week that that clinical workflow that they do doesn’t always make it into the note and that and they try to save time or use you know these EHRs are like we are going to reduce your documentation time. look at all these great tools that we have and some some of it kind of unfortunately takes away from from what they’re doing because it doesn’t give a specific enough description or or describe what they’re doing to the level of detail of to which they’re actually doing it. Um yeah, there’s actually an EMR that’s pretty popular. um they customize it under different names to a lot of different specialties. And that’s actually the system that the the practice is using that I’m reviewing the upupic for this morning. And Michelle, I told you right before we went live today, I’m just so frustrated in this review for the practice because the overuse of the templates and I know that this particular company encourages it. They sell their products saying they have legal backing. They say that they’ll help you in external audits, all of these things. They put tons of macros, tons of templates, very hard to see individualized patient information. Now, absolutely, I have total defense. everything is there that’s needed, but if it wasn’t so so much of this uniformity, you know, largely with just a little bit of patient information sprinkled throughout, we wouldn’t be in this situation. And they got a 100% denial on a UPIC. I feel very confident in the defense we’re going to have, but now they’re having to pay for that defense. There’s couple different law firms involved. I’m involved as a consultant and, you know, some others as well. So again, this comes at a cost and it’s not worth it. And we cannot rely on these other people or developers or whoever it is that’s painting this great picture for you with their products. You have to look at this objectively and see what it’s what it’s doing across the board, patient to patient, visit to visit. Yeah. And um I think that’s an excellent point. So yes, your documentation may be defendable, but what is that defense going to cost you at the end of the day? So why don’t we work towards having documentation that doesn’t need to be defended? And um that really is our goal as auditors and compliance professionals. So when we are meeting with you and giving you this information, sure your documentation may be defendable, but we don’t want you to have to pay for defense and we don’t want your staff to deal with 100% denials. That takes time. It costs money to do to do these things. So just keep that in mind. it, you know, when when you’re using these products or even when you’re documenting, is it something that you’re going to end up having to pay to defend later on? Because usually people pay attention to the almighty dollar. I do I do think Yes, I do think that’s an attention grabber, you know. Yes. But unfortunately, sometimes it doesn’t grab attention until it’s taken away. I know. I know. Which is not good. Yeah. And and we’re not saying that these tools aren’t effective and that they don’t have their place, but when you start when you start your note and it’s, you know, 95% template, maybe, just maybe, we should look at that. Yeah. Yep. Now, really quick, I I want to make sure we cover critical care quick and then talk a little bit about teleaalth because this, of course, is quite the issue right now. Um, so one thing I like about the update with critical care is we have more if then scenarios built in. And I’m always asked the question not necessarily, okay, how do I use the critical care codes? We know a lot about when to use an initial and then do the additional time beyond the initial code having 99291 99292. But where I want to focus some of the clarifications and highlight here is when we’re looking at the scenarios of same group and specialty sharing time, the split or shared critical care and same same day ENM with critical care services. Now Michelle, the the same group or specialty I see this a lot where we have, you know, maybe two different practitioners in one day. One is rounding making decisions in the morning, one’s coming in later in the day or the evening and they’re both looking at wanting to capture that time in the work. And you know, one thing that really stood out to me with this, and I I always try to focus on this a lot as well, when I’m I’m working oneon-one with people or with groups, we have to remember that this cannot be work that is essentially duplicating what was done earlier in the day. So if we have a second rounding, are they just checking on the patient from a monitoring perspective, not updating anything, not analyzing any information, not making any decisions, or is there distinct separate care? And we don’t always get to see that in documentation, especially because, you know, the hospital setting deals a lot with things like misuse of copy and paste, carry forward, um our macro statements. it it can be really difficult to see what is distinct in these situations. Yeah. And I think it’s a interesting time to use copy and paste. Um especially if you’re copying from another provers’s note, but that can be a discussion for a different day. Um, but I do like how they I do like how they included that table in there for critical care billing where it describes the multiple providers from the same specialty and then um, you know, combining combining the time because I think a lot of times that can be a little wishy-washy as well like can you combine their time to build this and how they you know say the first provider would build 99291 1, the other providers would build 99292 and then you’d combine the time to meet the 99291 threshold if needed. Um, is essentially what it is saying. Um, but I think that is an excellent thing for them to add to give that clarification to to because it is something in the hospital setting that they run into for the exact reason that you just said. And I think it those were great comments to add there to it about it being separate work. Um it’s not just because they stepped foot in that room to verify what the the provider left said essentially. Um it you know what was that separate work? Yep. And you know that’s going to be the same as well with split shared. So, one reminder here, I feel like we just I know not necessarily on the podcast here, but in our daily weekly work, we talk about split shared all the time and it gets exhausting. Um, one of one of the the members, my coding compliance connection members is dealing with a split shared situation that is just so frustrating. And, you know, I I feel for her because she every week is, you know, getting same questions. I have the same answer. The attorney is talking about only what’s defensible, not what would stop, you know, having to defend and it just creates a mess. But remember here, the same way we deal with issues of our physicians not wanting to be detailed in their own personal work, still think about that when we talk about this distinct component. And one thing that I find even with regular non-critical care split shared is that the physician wants to say uh you know a total of 60 minutes was spent I spent the the greater amount of time or they’ll say I spent over 35 minutes so they meet a threshold that they know they need and then they don’t have the A practitioner document time or they document it for them. Remember both people have to document their time. They should be documenting their work. That physician should not be saying, “I reviewed the note and agree. It’s not enough to stand on at the end of the day.” Now, remember, we’re looking at, okay, what would stop adverse findings on an external audit. I’m not talking from a defense standpoint. Obviously legally and from the compliance perspective, there’s all kinds of things that can be argued for split shared and really bad documentation, but that’s not our goal. That’s not what we want practices to pay for and where we want them to focus their revenue. So when we look at split shared, remember they’ve got to document their own work. Whoever spent the majority of the time is going to bill that out and you need that FS modifier still that’s going to show that that was split shared. Now lastly before we move on to tellaalth just a quick reminder that there is possibilities that you can have a regular ENM non-critical care ENM on the same day as critical care but the caveat there is the regular ENM service would have occurred prior in the day and typically this is more so when rapid events occur or the patient is you know quickly declining and they need to step in with that critical support. But um that that would be the situation when you can bill for both. Yeah. And I and I think they specified in here, of course, I can’t get back to where I highlighted on this, right? So much for highlighting, but I think they specified in there there could be zero overlap in in the service. Um, so keep that in mind when when billing that um critical care on the same day as an as an ENM service. Oh, here it is. Separate and distinct with no duplicative elements from the critical care service provided later in the day. Okay. Yep. So that would mean the note the note would need to be clear too, not one big progress note with everything mushed in there. So we got to see what’s happening distinct. Yep. Now for tea health a couple of things I want to talk about this for a minute because we of course are still in this holding pattern. This happens constantly. I’ve said over and over again I cannot stand um politics but sometimes in our industry we have to wait to see what the lovely men and women are going to decide for us. So currently what is happening is one thing actually let let me start with this. I’m very surprised that in the September update they specifically talk about in the red clarifications that our flexibilities are going away for for teleaalth services some of them October 1st and then they talk about the end of the year. Now with these flexibilities that they say are going away, it’s going to be the geographic restrictions, the location restrictions on where your provider can essentially be, limitations on the practitioners who are allowed to render those services, and then also um some of the other things that you know we don’t necessarily see or I should say I don’t see used as often as far as safety planning, uh caregiver training, some of those different things are wrapped up in there as well. Now, what I want to clarify as far as a certain state and my good friend and Michelle’s good friend as well, Terry Fletcher, she stays on top of politics. She stays on top of all of these things. So, for me, it’s helpful because I don’t have to listen to Congress. I’ll just wait to Terry for Terry to be like, “Okay, Stephanie, it’s time to look.” Yeah. So, one thing that is interesting is they’re trying to put in there, they’re trying to change the dates from the end of September to November 21st, meaning flexibilities would end November 22nd. But a lot of times what happens is they try to wrap these things into other bills and the other bills cause more of the arguments between the sides and they can’t agree. So, it’ll get, you know, pushed to the side. So currently that’s a situation we’re in. They’re not in agreement. We don’t have confirmation yet, but there is language out there that they’re trying to push the expiration to November 21st being the the last day and send instead of September 30th. So it’s important to come into this MLN and understand what those flexibilities are that are not permanent yet. Remember CMS has identified a lot of things as provisional meaning that currently you can do that but they have not permanently adopted it. There are some things within behavioral health substance use disorder where they have permanently made changes but we don’t have that across the board. And I know for myself I have a lot of clients that their whole business model will be affected if these things expire. So, we’re really, you know, closely waiting and watching to see what’s going to happen there. Um, one thing that I’ll I’ll just put in a quick plug again. So, Terry Fletcher and I did a big session last week. It was a webinar. It lasted an hour and a half. We did a complete deep dive on where teleaalth stands now. um specifics like CMS says inside of that MLN, what could be expiring, what we’re expected to expire. We talked a lot about, you know, clarifying what that means, how, you know, that can impact your practice, what you need to be ready for in the event that these expire. Um, that that was a live event last week, but we do have it ready. I’m working on getting that put out on demand. So, if anyone’s interested, just follow along on LinkedIn, different platforms here. You’ll see me announce that in a couple of days or maybe even later today. Um, we’re going to get that out there if you’re interested in purchasing that on demand to feel more comfortable with teleaalth. But, you know, I can’t reiterate this enough. There’s so many people that are, you know, banking the majority of their practices or, you know, even their patients. a lot of patients are becoming to rely on some of these services that can really be impacted soon if we don’t have permanent adoption uh by Congress at some point whenever they decide that’s going to happen. Um Terry will let me know. It’s so bad. I know. But I I just I can’t handle it. I got to stay in my my um my bubble, my safe place. I always say I got to put on the Grateful Dead and regground myself to get like away from this stuff. Um, but you know, just keep it in mind. We got to make sure that we’re on top of it, we got to make sure we’re paying attention and fully understand what all of these things mean because even just when we talk about geographic restrictions and location restrictions, those mean different things. Also, the practitioners rendering tellaalth, there’s a lot of them out there that are only allowed to because it was a part of a waiver and a flexibility. It’s not something that going forward everybody can just do even if they permanently adopt some of these flexibilities. So, a lot of unknowns there. Um, Michelle, is there anything else you wanted to say about tellaalth? I know we still in our audit work are finding variances every time we audit tell for sure. Um especially with tellaalth statements um I’ve seen instances where nothing is documented other than the visit type. That’s how I knew it was it was tellaalth. Um so really be paying attention and look at the broader picture of what’s required. I think that is something that um oftentimes can lead to a lot of questions surrounding what’s required for teleaalth. So pay attention to the whole picture and go to the different areas of what they’re saying is required. Um that was something you and I had talked about the other day was how all of the information is there. you just have to go to the appropriate cited sources within the instruction from CMS. So, make sure you’re looking through looking to all of that because they are giving the guidance. They’re just making you go piece it together. Yeah. Yep. Which makes it hard. You got to string it all together through all of the different links and the the little um path that they lead you down. Or you can pay attention to Terry Fletcher’s content and she will she will put the puzzle together for you. Yes, she she is great at that. Big plug for Terry because she she really is. Pay attention to, you know, everything she’s she’s posting. She’s very active on LinkedIn and you can get a lot of information just from what she’s posting there. So, and opposite of me, Terry actually loves politics. So, she’s uh right on that side of it. So, um now I just want to close real quick with uh an update. So, next week what we’re going to be diving into is this proposed Sigma change. I say proposed because there’s so many people in opposition of it. We’ll see if they back out last minute, but as of right now, Sigma, as of October 1st, is getting ready to move forward with their big policy change to auto down code. I think this is going to really, really disrupt revenue and practices. And there’s different things that we need to be ready for, watch out for, and um pay attention to if you bill or if you network and and participate with Sigma. So, hope to see you all back next week and enjoy the rest of your week. [Music]
In this episode of Auditing Antics, we dive into the latest CMS updates for E/M services, effective Sept 2025. We will break down the changes you need to know to stay compliant and optimize coding accuracy. Perfect for auditors, coders, and compliance professionals looking for a clear, practical guide.
#MedicalCoding #EMUpdates #CMS2025 #HealthcareCompliance #AuditingAntics #Telehealth #CriticalCareBilling #HealthcareAuditing #EMservices #MedicalAudit #RevenueCycle #CPTCoding #Podcast #StephanieAllardConsulting
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