Audit & Documentation Webinar Recap

Our second Practice Engagement Program webinar this month featured Mike Demi, RN, CHC, CPC, CPMA, CSFAC  (wow that’s a lot of credentials!), Senior Consultant for Medical Compliance Associates and after nearly 90 minutes, the virtual hand raising, Q & A’s and chats were still rolling in! For those who missed it, no need to worry as the live recording and presentation PDF is now uploaded to the member-only library.

In case you are wondering what we covered, here is a preview:

  • RAC Audits
    • Did you know that auditors are making commissions of up to 17.5% on takebacks?!
    • The most targeted audit areas and ways to improve documentation to reduce the chance of final denials and future takebacks including:
      • AFOs (custom and pre-fabricated)
      • E/Ms with procedures (using a 25 modifier)
      • Surgical Dressings
      • Facility vs. Non-facility work
      • And of course... Therapeutic shoes and inserts for diabetic patients
  • Medicare DME and "Same or Similar"
    • Why they will deny (even if it doesn't make sense)
    • How to find out if a patient has received something "same or similar" in the past 5 years
    • When to have patients sign a statement that they do not recall receiving a "same or similar" device followed by an ABN if they have
    • When and how to appeal denials (verbiage tips, circumstances and examples of when you should "win")
    • Big reimbursement differences = more than minimal self-adjustment
  • Diabetic Shoe documentation changes (verbiage, number of required "pieces of paper")
    • DWO is now SWO
    • The trouble with getting PCPs to "agree" to your findings
    • Timelines and dispensing
    • Charting verbiage to pass audits with flying colors
  • Clarification of A5513 versus A5514 (ask your lab/shoe company which you should use and hope they know)...
  • There was more but it's probably better if you just watch it!

Thank you again Mike Demi from Medical Compliance Associates for sharing your vast knowledge and for preparing and defending podiatrists coast to coast!

It's nice to have friends who are (as we say in Boston) "wicked smart" (except say it without the "r" in smart).

For more information on the services and packages provided by Medical Compliance Associates visit:

The full webinar recording is available to our Practice Engagement Program (PEP) members in the member-only library.

Not yet a member of PEP? What are you waiting for??

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