Audit Manager Professional Release Notes 2022

December 2022

1. This release contains the changes made to the E/M suggested code logic effective on 1/1/2023.   These changes will be automatically applied when a date of service (DOS) is on or after 1/1/2023.   DOS before 1/1/2023 will use the existing logic.  For DOS before 1/1/2023, the new E/M guidelines are applied only to the Office and Other Outpatient codes.  Titles within Audit Manager have been updated to show that 2021/2023 guidelines will be applied as appropriate.   
2. Below is a list of the Types of Services that have been added or enhanced within the Audit Box.  We have added messages below either the Type of Service or Type of Visit directing you to either the MDM or Time sections or both as appropriate for the options selected.   If you select Emergency Department Services, you will see a message directing you to the MDM section as Time is not an option for these codes. 
3. Clinical Staff Services (99202-99215) – This Type of Service requires you to select the corresponding Office or Other Outpatient Service code billed by the physician on the same DOS.  The physician can bill with MDM or Time; however, Clinical Staff Services can only use Time. 
4. Emergency Department Services (99282-99285) – Only MDM can be used for these codes. 
5. Cognitive Assessment and Care Plan Services (99483) – New logic has been added to support these codes which can only be billed using time. 
6. Home or Residence (99341-99350) – Domiciliary codes have been deleted.  This code range is used instead.  These codes are billed based on whether the patient is new or established.  When Time is used to select the level of service, prolonged services codes will be automatically suggested when appropriate. 
7. Hospital Inpatient & Observation (99221-99233) – These services are separated into initial and subsequent categories.  Both MDM and Time can be used to report these codes.  When Time is used to select the level of service, prolonged codes will be automatically suggested when the time entered exceeds the maximum time for the basic codes. 
8. Hospital Inpatient & Observation Discharge Service (99238, 99239) – Only Time can be used for these codes. 
9. Hospital Inpatient & Observation including Admit & Discharge (99234-99236) – Prolonged codes will be automatically suggested when the time entered exceeds the maximum time for the basic codes. 
10. Inpatient & Observation Consultations (99252-99255) – Can be billed using MDM or Time.  When Time is used, the prolonged codes will be automatically suggested when the time entered exceeds the maximum time for the basic codes. 
11. Inpatient Neonatal Intensive Care, Pediatric/Neonatal Critical Care (99468-99476) – Currently this Type of Service is for intensive and critical care for both neonates and pediatric patients.   In January’s release, we will be revising these codes to make them easier to utilize. 
12. Medicare Visit and Wellness Visits (G0402, G0438, G0438) – We have retitled this set of codes from Annual Wellness to be more specific to their Medicare specific application.   In the January release, we will be adding logic for the IPPE visit.  Until then there is no automatic logic for the IPPE visit. 
13. Nursing Facility Care Services (99304-99310) - Prolonged codes will be automatically suggested when the time entered exceeds the maximum time for the basic codes. 
14. Office or Other Outpatient Services (99202-99215) - Prolonged codes will be automatically suggested when Time is used to select the level of service and the time entered exceeds the maximum time for the basic codes. 
15. Office or Other Outpatient Consultants (99242-99425) – Either MDM or Time can be used for these codes. Prolonged codes will be automatically suggested when the time entered exceeds the maximum time for the basic codes. 
16. Telephone Services (99441-99443, 98966-98972) – We have corrected an error and unclear options for Non-Face-To-Face and Non-physicians E/M Assessments.  We removed the Non-Face-To-Face options and consolidated both physician and non-physician into this Telephone Services.   For clarity we have defined Physicians as including Advanced Practice Clinicians for selecting the Type of Visit.  The second Type of Visit, non-physicians, is for other providers as defined in the medical section of CPT. 

November 2022

The 2023 E/M Comparison Report is now available. This report displays both the 2022 and the 2023 E/M codes for training purposes.  Audit Manager will not automatically suggest the 2023 value for you, but you can manually enter it. To use this feature, there are two options in Audit Guidelines that need to be turned on.

1. Turn the option “E/M 2021 Assessment Required:” to Yes.
2. Within the Audit Guidelines’ Assign Report Parameters selection the report option titled “Provider/Coder Project Detail 2023 E/M Comparison”. When the Comparison feature is turned on you will be allowed to enter a second audited code which will then be displayed on the Provider Detail report.  Please see the Knowledge Base for additional instructions.  For help beyond the article please reach out to Client Support.

October 2022

1. We have been updating the technology behind uploading bulk import files of encounter and medical records that improves performance and encryption/decryption of these files.  
2. Corrected an error in Missing Data that compressed notes into an unreadable size. 
3. Corrected an error that allowed We applied three enhancements to Audit Manager over the past weekend.
4. Corrected an error that allowed users to change their own account type to a higher level. This error was fixed but is causing SOME users to not be able to view the Provider Detail, Worksheet Detail and Provider Data Files.   We are fixing this problem and expect to have it fixed in the next 4-6 hours.  We apologize for the inconvenience. 
5. Improved the technology supporting uploading of PDF files (typically medical records) so these files can be uploaded. 
6. Corrected an error in the Missing Data notes that compressed notes so they are unreadable. 

September 2022

We want to let you know we have corrected several problems with the Run Edits functionality.

1. The NCCI edits were not being applied when one of the codes was a HCPCS code. This has been fixed.
2. We have corrected alerts occurring since the July 2022 quarterly update, incorrectly identifying codes G0100, GO438 and G0438 as invalid.

August 2022

1. Modifier Fields - There was inconsistency between the number of characters allowed in the modifier fields of the Audit Box and the Bulk Import files. The Bulk Import files allowed up to 12 characters to accommodate situations where these fields are repurposed for custom modifiers and codes.  All the fields in the Audit Box now accommodate up to 12 characters for consistency. 
2. Billed and Paid - Fields have been added to the Audit Box and Bulk Import files to collect these data elements. You can populate these fields when you desire to collect financial information on prepayment and post payment.  While the first field is labeled Billed you can enter any value representing prepayment amounts.  If you do not want to collect this data, you can leave these fields blank.
3. Missing Data – We have enhanced the missing data feature to improve efficiency. You can now select multiple rows, add, or change the status, sub status, or add a note to multiple records. Note: you do not have to change all three fields.  You can perform a subset of these actions.
4. When you are on the Missing Data option, click on Actions to either change the status and/or add notes. Select the rows to which you apply actions. Within the Action menu, select the new option titled Add Status and Notes.  A pop-up window will be displayed where you can take whatever action you want applied to all selected rows.

May 2022

1. Previously users could not tab through all fields in AM, specifically gender and POS, that were radio buttons. Tabbing now includes both fields.
2. The Type of Visit field was automatically clearing when users changed the date of service. This is no longer happening.
3. Clinical Logic Support - The following neonatal/pediatric code sets have enhancements to accommodate different places of service based on patient's age/weight on the dates of service as defined by CPT.
4. New newborn, initial – 99460, 99461
5. New newborn, subsequent - 99462
6. Initial admit/discharge same day- 99463
7. Attendance delivery - 99464
8. Delivery/birthing room CPR - 99465
9. Neonatal/pediatric critical care, initial per day – 99468, 99471, 99475
10. Neonatal/pediatric critical care, subsequent per day – 99469, 99472, 99476
11. Initial hospital care -99477
12. Subsequent hospital care – 99478, 99479, 99480
13. Critical care transport – 99466-99467
14. Control physician transport – 99485

April 2022

1. Added Taxonomy to Specialty - We have enhanced the Audit Manager’s specialty list to also include taxonomy codes. All 856 taxonomy codes and their descriptions have been added to Audit Manager.  Because we have added and will maintain a complete list of taxonomy codes users will not be able to edit or modify taxonomy codes or descriptions. Clients currently using specialty codes can continue to use them.  Clients using Claims Connect and/or Analytics will only be able to use taxonomy codes.  When bulk uploading providers the system will accept either specialty or taxonomy.  
2. Claims Connect Search - We have modified the claim search for Claims Connect not executed automatically. You now click on the Search button once you have entered all the criteria you want including diagnosis, procedure codes, modifiers, etc.
3. Syncing Audits on the Project List - We have made improvements to how projects and audits are synced. We anticipate this will resolve the recent problems with updates not being made to projects.

February 2022

1. We have enhanced functionality in the Audit Box for Transitional Care Management codes. The MDM box is enabled and will suggest the appropriate code based on the number of days after discharge the face-to-face visits occurred AND the level of MDM.
2. We added a new Type of Service for Medical Nutritional Therapy codes. The Audit box will suggest the number of codes allowed based on the time.

January 2022

1. Changes made to the Project Summary report in December caused some unanticipated problems with the Audit Box and QA Alerts.  The Audit Box was fixed earlier in January.  The QA Alerts are now repaired with changes applied today.
2. For clients using Claims Connect, the diagnosis indicators on individual lines in the Audit Box have not been displayed.  They are now displaying correctly.
3. A discrepancy between the E/M Audit Score on the Project Summary and E/M Audit Failure report was fixed.
4. On the Manage Files page we added the name of the person who uploaded the file and the comments entered by that person.  This information will help you resolve issues with uploaded records.
5. On the Submit Files page we increased the number of files that can be submitted from 50 to 500.  The tab and browser used to upload files must be kept running until file submission is complete.  See the notes on the web page for additional information.
6. We modified the Excel report on the Missing Data page to increase its usability. Previously the auditor’s notes identifying the missing information, auditor’s name, note date and time, were all combined with system generated notes.   These items have been moved into separate columns to allow users to easily delete information they do not want sent to clients.
7. We have modified the Audit Box to activate the 2021 Time-Based coding box when users select “Time Based E/M Service”. Previously only the Office/Outpatient Visit option activated the 2021 E/M options.  Further enhancements will be made in coming releases to TCM based on requests from various users.
8. On the Pending Assignments page, we have added the ability to run a Provider Detail for selected audits within the Action menu.