Auditing Antics: Navigating Medical Coding and Auditing

This episode explores a common misconception in healthcare documentation: using words or phrases from the E/M guidelines does not automatically support a higher level of complexity or risk. We discuss why documentation must reflect the actual medical decision-making, patient condition, and care provided, and offer practical guidance for creating notes that align with compliance and coding standard...

In this episode, Skin Substitutes 2026: CMS Coverage vs Payment, we break down the growing confusion surrounding CMS’s decision to withdraw the Final Local Coverage Determinations for skin substitutes and what that decision does, and does not, mean for providers. With many assuming the LCD withdrawal delays or stops upcoming reimbursement changes, we separate fact from fiction and explain why that...

‘Tis the season for reflection—and preparation! In this special holiday episode of Auditing Antics, “Audit Under the Mistletoe: 2025 Wrap-Up & 2026 Prep,” we cozy up with a review of the year’s key coding and compliance insights and set the stage for a successful 2026. Whether you’re a coder, auditor, or compliance professional, this episode will help you end the year informed, inspired, and r...

Join us on Auditing Antics as we break down the world of Evaluation & Management (E/M) services, one data element at a time. In this episode, we’ll analyze key data elements, uncover common documentation pitfalls, and explore how accurate coding drives compliance and revenue integrity. Perfect for auditors, coders, and compliance pros looking to sharpen their skills with real-world insights an...

In this special Thanksgiving episode, Stephanie and Michele take a heartfelt pause to reflect on the people and moments that make the world of medical coding and compliance something to truly be thankful for. From supportive teams and passionate educators to the coders and auditors who keep healthcare running smoothly, this conversation is all about gratitude, connection, and community.#AuditingAn...

In this episode, Stephanie and Michele tackle your most pressing medical coding and compliance questions in real time! From tricky documentation scenarios to evolving regulatory updates, they’re diving into what’s keeping coders and compliance pros up at night. Tune in for practical insights, real-world examples, and a few laughs along the way.#AuditingAntics #MedicalCoding #ComplianceTalk #Health...

Join us with special guest Yoelvis Reyes, CPC, CRC, for an inspiring discussion exploring the evolving world of medical coding where English and Spanish-speaking professionals come together to share insights, opportunities, and challenges shaping the future of our field. We’ll dive into AI’s impact on coding, the growing demand for bilingual talent, key traits employers seek, and how education in...

In this episode of Auditing Antics, Stephanie sits down with Ron Chapman II, one of the nation’s top federal healthcare defense attorneys, to unpack the growing wave of UPIC audits and investigations in wound care—especially those involving skin grafts and cellular/tissue-based products. A former prosecutor and U.S. Marine Corps Judge Advocate, Ron brings a powerful dual perspective on how enforce...

Gather around the (virtual) campfire as we share real-life “horror stories” from coding audits gone wrong! From missing modifiers to documentation disasters. Learn how to turn these coding nightmares into compliance success stories.#MedicalCoding #AuditHorrorStories #HalloweenSpecial #CodingCompliance #MedCoderLife #MedicalAuditing #RevenueIntegrity #HealthcareCompliance #CodingEducation #Healthca...

In this episode, we unpack how a federal government shutdown could affect Medicare telehealth services—from delays in policy updates and payment processing to disruptions in provider support and patient access. We’ll explore what providers and beneficiaries should know, how to stay compliant during uncertainty, and what safeguards may (or may not) be in place to keep telehealth running. Tune in fo...

In this eye-opening episode of Auditing Antics podcast, we turn the spotlight on you the auditor and coder. What risks come with reviewing others’ work, and how can you avoid becoming part of the compliance problem yourself? We’ll explore real-world scenarios where professional judgment, documentation, and ethical lines blur and share practical steps to protect your license, credibility, and caree...

Join us as we discuss the essentials of ICD-10-CM diagnosis coding, common documentation pitfalls, and the compliance red flags every auditor, coder, and compliance professional should recognize. Whether you’re coding for accuracy or auditing for integrity, this episode delivers real-world insight with compliance clarity.#AuditingAntics #ICD10CM #MedicalCoding #CodingCompliance #HealthcareAuditing...

Link to On-Demand Telehealth Event: https://www.stephanieallardconsulting.com/online-shop/p/the-future-is-now-2025-the-next-era-of-telehealth-compliance-and-coding Starting October 1, 2025, both Aetna and Cigna are set to implement automatic downcoding policies for evaluation and management (E/M) services, without even reviewing clinical documentation. In this episode of Auditing Antics, we break...

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 #CriticalCar...

The global surgical package can be tricky. Trying to figure out what is included, what’s not, and how to code it right. In this episode, we clear up the confusion with practical tips to help stay compliant!#MedicalCoding #BillingCompliance #GlobalSurgicalPackage #HealthcareBilling #CodingTips #RevenueCycle #MedicalBilling #Medical #Healthcare #Compliance #HealthccareCompliance #MedicalAuditing #Re...

It’s time for your questions to take the spotlight! In this Q&A session, we’re diving into the everyday challenges medical coders, billers, and compliance professionals face. From gray areas in documentation to tricky billing scenarios and compliance red flags, we’ll tackle it all with practical strategies and clear guidance. Tune in for straightforward answers that can help you avoid denials,...

In this episode, we shine a light on one of the most common—and costly—mistakes in medical coding: making assumptions. Whether it’s inferring a diagnosis, assuming laterality, or “filling in the blanks” when documentation is unclear, assumption-based coding opens the door to compliance risks, denials, and even audit findings.#MedicalCoding #RevenueCycle #Compliance #MedicalBilling #HealthcareCompl...

Timely provider signatures aren’t just a formality—they’re the green light for revenue flow. Learn how late or missing sign-offs can cost your organization, and strategies to keep documentation on schedule.#MedicalCoding #HealthcareCompliance #MedicalAuditing #CMS #Documentation #AuditReady #MedicareCompliance #CodingEducation #HealthcarePodcast #AuditingAntics #ChartAudits #MedicalNecessity #Comp...

In this episode of Auditing Antics, we dive into the growing concerns surrounding the use of templates in documentation and how CMS views their impact on medical necessity, specificity, and over-documentation. Understanding the risks of cloned or boilerplate notes is critical to protecting your organization from denials or recoupments. 🩺✨ We are excited to announce our new merchandise collection...

When you're an in-network provider, charging for administrative tasks could violate your payer agreement. We dig into real-world examples and offer practical tips to navigate this growing gray area without triggering compliance issues.#MedicalBilling #HealthcareCompliance #RevenueCycle #MedicalCoding #AuditReady #AdminFees #InNetworkProviders #PayerContracts #HealthcareLaw #AuditingAntics #Billing...

When your medical practice is facing an external investigation, preparation and understanding are your best defense. In this episode with Sean Weiss and Eric Rubenstein, we will break down how to navigate the complex process of medical coding and billing investigations whether prompted by the government, a commercial payer or a whistleblower complaint. Tune in for practical tips and expert insight...

During this episode we will be joined by special guest Scott Kraft and dive into the real-world challenges of working with providers who are overwhelmed, frustrated, and sometimes resistant when it comes to coding and compliance. We will explore the reasons behind pushback, the impact of burnout, and how to bridge the gap between clinical care and regulatory requirements. Reach Out For Compliance...

Medicare spending on skin substitutes has skyrocketed jumping from $256 million to over $10 billion in just five years. In this episode, we explore how CMS is addressing abuse, fraud, and excessive pricing with bold policy shifts that could cut spending by 90%. Let’s talk compliance and cost control. #MedicalCoder #MedicalCoding #MedicareSpending #CMS #SkinSubstitutes #HealthcareCompliance #CMSUpd...

In this episode, we dive into the critical role internal audit plans play in staying ahead of payer denial patterns and revenue integrity. With denials on the rise and payers shifting requirements without warning, medical coding and compliance teams must be proactive, not reactive. Go to https://www.stephanieallardconsulting.com/ to download the audit plan now! Reach Out For Compliance Help Now! h...

I’m excited to have Dr. Khush Singh join me in the studio for an important and timely discussion related to value-based care and the growing pressure around accurate coding and documentation especially when it comes to HCCs. In this episode, Dr. Singh and I will unpack what RADV audits really focus on, why precise HCC documentation is more important than ever, and how even small gaps can lead to m...