Tag: audit

How To Survive A CME Audit

How To Survive A CME Audit

The Medical Practice Act (MPA] and Rules require everyone licensed under the MPA — DCs, MDs, and DOs — to obtain 150 hours of Continuing Medical Education [CME] for the 36 months preceding July 31 in the year of renewal. All 150 hours may be obtained in formal “Category I” hours or may be divided into two categories, 60 hours of formal education and 150 hours of informal.

Read More
Results of an Audit: a Case Study

Results of an Audit: a Case Study

Some time ago I worked with a client who needed help with an appeal. The provider had seen a patient over the course of four weeks for severe low back pain with radiculopathy to the left calf and foot. The provider put together a care plan and outlined goals based upon functional deficiencies. At each encounter, the following codes, among others, were billed:97110 Therapeutic exercises, 97140 Manual therapy. The therapy services were denied for most of the visits. The claims reviewer provided the following partial explanation for the denial:

Read More
Loading

Select A Category