Auditing Antics: Navigating Medical Coding and Auditing

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 break down why billing under the wr...

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, audio only limitations, consent, an...

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 significant consequences. We discuss the r...

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, and compliance oversight, including ...

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 walk through what qualifies as a t...

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 analyzing the full clinical picture...

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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 roles, physician involvement, and docume...

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.”In this episode of Auditing Antics...

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, Stephanie and Michele break down how da...

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 documentation? And what are auditors actually t...

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 because compliance mistakes can happen ...

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Got coding questions you’ve been sitting on because the answer isn’t quite clear? This live Auditing Antics Q&A is where real-world healthcare coding an...

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.

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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 decision-making, the compliance risks t...

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 Help Now! https://www.stephanieallar...

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 standards.

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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 assumption creates real compliance...

‘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 ready to tackle 2026 with confidence...

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 and practical tips.#AuditingAntics #E...