Auditing Antics: Navigating Medical Coding and Auditing

Join us for an E/M Q&A on Documentation, MDM, and Time as we answer some of the most common questions providers, coders, billers, and compliance professionals face. From selecting the correct E/M level to understanding medical decision making requirements and time-based billing rules, we'll break down real-world scenarios, audit risks, and documentation tips to help you improve compliance...

Summer can be one of the busiest times of year for healthcare coding, billing, auditing, and compliance professionals, making it easy to overlook the signs of burnout. In this episode of Auditing Antics, Stephanie and Michele discuss the realities of summer burnout in healthcare compliance and share affordable, practical ways to recharge without spending thousands on a vacation. From staycations a...

In this episode of Auditing Antics, Stephanie Allard and Michele Strickland discuss one of the most overlooked compliance resources in healthcare, the back of the CMS-1500 claim form. Every claim submitted includes certifications related to medical necessity, supervision, billing accuracy, and regulatory compliance, making it clear that compliance extends far beyond documentation. Join us as we ex...

Telehealth has become a routine part of healthcare delivery, but one of the most important compliance requirements is often overlooked: location. In this episode of Auditing Antics, Stephanie and Michele discuss why the physical location of both the patient and the provider matters during a telehealth encounter. From state licensure requirements and payer policies to documentation expectations and...

Artificial intelligence is no longer a future concept in healthcare. It is already impacting documentation, coding, auditing, revenue cycle operations, and compliance. The question is no longer whether AI will affect healthcare coding, but how quickly the industry will change and what professionals can do to prepare. In this episode of Auditing Antics, Stephanie Allard and Michele Strickland take...

For this episode of Auditing Antics, we are diving into one of the biggest misconceptions in the healthcare coding and compliance industry: credentials alone do not automatically advance your career. While certifications can open doors, true career growth often comes from how you apply your knowledge, build experience, develop professional relationships, and navigate opportunities throughout your...

As Mental Health Awareness Month comes to a close, this episode of Auditing Antics: Navigating Medical Coding and Auditing focuses on one of the most questioned areas in healthcare today: behavioral health documentation, billing, and audit risk. Stephanie and Michele answer real world questions surrounding psychotherapy documentation, E/M with therapy services, time based coding, telehealth requir...

In this episode of Auditing Antics, we break down the complex world of psychological and neuropsychological testing services from the perspective of documentation, coding accuracy, reimbursement, and compliance risk. We discuss the differences between psych and neuropsych testing, how time and testing components should be documented, common coding and billing mistakes, and the audit vulnerabilitie...

Psychotherapy services continue to be a major focus in behavioral health audits, payer reviews, and documentation denials. In this episode of Auditing Antics, we break down psychotherapy billing from an auditor’s perspective, including what documentation actually supports the service billed, how time based services are reviewed, and the common red flags that trigger denials and compliance concerns...

Substance Abuse and Mental Health Services Administration (SAMHSA) https://www.samhsa.gov/find-helpMay is Mental Health Awareness Month, and this episode of Auditing Antics focuses on the conversations our industry avoids. Medical coding, auditing, and compliance demand constant accuracy and productivity, but rarely address the mental toll behind that work. From audit pressure and denials to decis...

This episode takes a closer look at one of the most common and dangerous billing issues in healthcare operations: reporting services under the wrong provider’s NPI. What may seem like a simple administrative shortcut can quickly turn into a significant compliance problem when the documentation, supervision, credentialing, or actual rendering practitioner do not match the claim. In this episode, I...

A focused episode answering the most common and highest-risk telehealth questions coming in right now. This episode cuts through confusion around what is actually allowed versus what is temporarily permitted, and where organizations are making assumptions that are leading to denials and audit exposure. Expect clear answers on documentation requirements, place of service selection, modifier usage,...

In this episode of Auditing Antics, we recognize Stress Awareness Month with an honest conversation about the mental load and stress that comes with working in medical coding, billing, and compliance, where there is constant pressure to be accurate, meet productivity expectations, stay current with changing guidelines, and navigate audit risk while knowing that even small mistakes can have signifi...

In this episode of Auditing Antics, we ask the questions every practice should be asking, but many are not, when it comes to their risk adjustment and HCC coding processes. Are your workflows built around accuracy and clinical integrity or are they driven by capture and convenience? We walk through the critical questions that uncover gaps in documentation, coding practices, provider involvement, a...

This is not just a policy update, it is a shift in workflow. In this episode of Auditing Antics, we break down what UnitedHealthcare (UHC) is really changing and why so many providers are at risk without realizing it. If you are reviewing imaging on the same date as an E M service, that work may no longer be separately reimbursed unless it meets strict interpretation and reporting requirements. We...

In this episode of Auditing Antics, we explore how coding skills evolve through auditing and what it really means to take your knowledge to the next level. While coding provides the foundation, auditing requires a broader focus on documentation integrity, medical necessity, and compliance risk. We break down the key mindset shifts and practical skills needed to move beyond code selection and into...

Visit the etsy shop at sallardconsulting.etsy.com Spravato treatment includes a required two-hour observation period, but many clinics are unclear about what that time should actually involve. In this episode, we explore what needs to happen during the monitoring period and how clinical care responsibilities differ from billing and compliance expectations. We discuss patient monitoring, staff role...

Go to https://www.stephanieallardconsulting.com/online-shop/p/peripheral-vascular-lower-extremity-interventions-coding-and-compliance-essentials-1 and use code VASC15 at checkout for a discount on the upcoming Peripheral Vascular Lower Extremity Interventions: Coding and Compliance Essentials Event! There’s a phrase in compliance that should make every practice pause:“We’ve always done it this way...

Most audits don’t start with a complaint. They start with a pattern. Long before a human reviewer opens a chart, payer analytics are scanning utilization trends, benchmarking providers against peers, and flagging statistical outliers. Sudden shifts in coding levels. High-frequency services. Modifier usage patterns. Even documentation that looks too consistent. In this episode of Auditing Antics, S...

Physicians document to reflect clinical care. Auditors review to validate compliance and billing accuracy. Same chart with a completely different lens. In this episode of Auditing Antics, we break down the mindset gap between providers and medical coding auditors. Why does something that feels clinically obvious sometimes fail an audit? Why does intent not always translate to compliant documentati...

Burnout impacts morale and accuracy. In this episode of Auditing Antics, Stephanie and Michele unpack how exhaustion, staffing strain, and constant regulatory shifts quietly increase compliance risk. When teams are stretched thin coding patterns may change. Small oversights turn into denials, downcoding, or audit findings. We’re connecting the dots between human fatigue and operational exposure be...

Find the Medical Coding Workroom Here! https://www.stephanieallardconsulting.com/medical-coding-workroom-1 Find the Membership (that includes the Medical Coding Workroom) Here! Use code AUDITINGANTICS26 for a 26% discount https://www.stephanieallardconsulting.com/membership Got coding questions you’ve been sitting on because the answer isn’t quite clear? This live Auditing Antics Q&A is where...

What happens when a vaccine visit ends with education, but no immunization is administered? In this episode, we break down when immunization counseling may be reportable, what documentation is required, and the audit risks when vaccines are refused or deferred. Join us to learn about the new 2026 vaccine counseling codes. Reach Out For Compliance Help Now! ⁠https://www.stephanieallardconsulting.co...

Automatic E/M downcoding has become an increasingly common, and often unquestioned, practice in payer reviews and internal audits. In this episode of Auditing Antics, we break down what automatic downcoding is, why it happens, and when it crosses the line from compliance review into improper reimbursement reduction. We discuss how payers apply internal “rules” that override documented medical deci...

Remote Patient Monitoring is often marketed as easy, hands-off revenue, but that mindset is exactly why RPM programs fail audits. In this episode of Auditing Antics , we explain why RPM is not passive income, what active provider involvement and documentation are required, and how treating RPM like an automated service can lead to denials, recoupments, and compliance risk. Reach Out For Compliance...