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 this creates for providers, and how organizations can identify, challenge, and defend against inappropriate downcoding. If you’ve ever seen well-supported E/M services reduced without explanation, this episode will help you understand what’s happening and what to do next.Reach Out For Compliance Help Now! https://www.stephanieallardconsulting.com/contact

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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.stephanieallardconsulting.com/contact

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Find our AUDITING ANTICS PODCAST for regular updates and discussions related to compliance in the medical coding and billing industry! https://www.stephanieallardconsulting.com/auditing-antics-podcast

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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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Find our AUDITING ANTICS PODCAST for regular updates and discussions related to compliance in the medical coding and billing industry! https://www.stephanieallardconsulting.com/auditing-antics-podcast

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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 and financial risk.Reach Out For Compliance Help Now! https://www.stephanieallardconsulting.com/contact

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Find our AUDITING ANTICS PODCAST for regular updates and discussions related to compliance in the medical coding and billing industry! https://www.stephanieallardconsulting.com/auditing-antics-podcast

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‘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—no mistletoe mishaps required!#AuditingAntics #MedicalCoding #HealthcareCompliance #AuditPlanning #TPE #RevenueCycle #CodingUpdates #2026Audits #HolidayWrapUp #ComplianceTips #HealthcareAudits #CodingLife #AuditReady #MedicareCompliance #HIPAA #RiskManagement #CodingCompliance #AuditSeason #HealthcareRevenue #RevenueIntegrity #MedicalAudit #ComplianceMatters #CodingExcellence #HealthcareUpdates #AuditInsights #MedicalBilling #ComplianceStrategy #YearEndReview #NextYearPrep #AuditChecklist #HolidayCompliance #PodcastForCoders #HealthcarePodcast #MedicalCodingPodcast #CompliancePodcast #RevenueCyclePodcast #AuditPodcast #MedicareAudit #HealthcareLeadership #MedicalCompliance #CodingCommunity #HealthcareProfessionals #AuditTalk

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 #EMData #DataAnalyzed #MedicalCoding #HealthcareCompliance #RevenueIntegrity #AuditLife #CodingAudit #EMServices #EvaluationAndManagement #HealthcareAuditing #DocumentationMatters #CodingCompliance #RevenueCycle #AuditInsights #MedicalAuditing #DataDriven #AuditEducation #HealthcareData #CodingTips #ComplianceTips #AuditTips #EandMServices #AuditDeepDive #CodingLife #AuditAnalytics #HealthcareCoding #MedicalRevenue #ComplianceAudit #ChartReview #EMCoding #AuditEducation #HealthcareAudit #RevenueCycleManagement #DataDissected #CodingExcellence #AuditCommunity #MedicalDocumentation #AuditReview #HealthcareInsights #RevenueIntegrityMattersReach Out For Compliance Help Now! https://www.stephanieallardconsulting.com/contact

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Find our AUDITING ANTICS PODCAST for regular updates and discussions related to compliance in the medical coding and billing industry! https://www.stephanieallardconsulting.com/auditing-antics-podcast

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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.#AuditingAntics #ThankfulAndCompliant #ThanksgivingEpisode #MedicalCoding #HealthcareCompliance #CodingCommunity #ComplianceProfessionals #HealthcareAuditing #MedicalAuditing #RevenueIntegrity #DocumentationMatters #ComplianceTalk #CodingEducation #HealthcarePodcast #CoderLife #BillingAndCoding #ComplianceMatters #ComplianceTips #HealthcareLeaders #ComplianceCulture #HealthcareRevenueCycle #GratefulCoders #ComplianceCommunity #CodingProfessionals #HealthcareIndustry #ProfessionalGrowth #ComplianceEducation #HealthcareHeroes #MedicalBilling #ContinuousLearning #GratitudeInHealthcare #ComplianceAwareness #ComplianceLifeReach Out For Compliance Help Now!https://www.stephanieallardconsulting.com/contactSign up for our updates and the latest compliance news here! https://www.stephanieallardconsulting.com/Find our AUDITING ANTICS PODCAST for regular updates and discussions related to compliance in the medical coding and billing industry!https://www.stephanieallardconsulting.com/auditing-antics-podcastView our compliance consulting, auditing, and education services here! https://www.stephanieallardconsulting.com/servicesView our Coding Compliance Connection membership here! https://www.stephanieallardconsulting.com/membership View our online shop here! https://www.stephanieallardconsulting.com/online-shopView our Etsy shop here!https://sallardconsulting.etsy.com

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 #HealthcareCompliance #CodingEducation #AskUsAnything #LiveQandA #HealthcareAuditing #MedicalAuditing #CodingCommunity #ComplianceTips #HealthcareRegulations #DocumentationMatters #CodingLife #ComplianceProfessionals #HealthcarePodcast #CoderLife #BillingAndCoding #RevenueIntegrity #ComplianceEducation #Podcast #StephanieAllardConsulting #AuditingAnticsPodcastReach Out For Compliance Help Now!https://www.stephanieallardconsulting.com/contactSign up for our updates and the latest compliance news here! https://www.stephanieallardconsulting.com/Find our AUDITING ANTICS PODCAST for regular updates and discussions related to compliance in the medical coding and billing industry!https://www.stephanieallardconsulting.com/auditing-antics-podcastView our compliance consulting, auditing, and education services here! https://www.stephanieallardconsulting.com/servicesView our Coding Compliance Connection membership here! https://www.stephanieallardconsulting.com/membership View our online shop here! https://www.stephanieallardconsulting.com/online-shopView our Etsy shop here!https://sallardconsulting.etsy.com

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 Spanish can open new doors in healthcare. Whether you're a seasoned coder or just starting out, this conversation will help you see how to stand out, grow, and thrive in a changing industry.

Check out Codingforhealth and Yoelvis here!https://codingforhealth.com/home#MedicalCoding #HealthcareCompliance #BilingualCoding #CodingCareers #HealthcareProfessionals #AIinHealthcare #MedicalBilling #HealthInformationManagement #FutureOfCoding #BilingualProfessionals #RemoteCoding #CodingEducation #HealthTech #FutureOfHealthcare

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 enforcement actions take shape and what providers can do to stay protected. Together Stephanie and Ron will explore recent audits they are collaborating on and identify the fine line between medical necessity and overutilization, how documentation can make or break a case, and what recent UPIC trends reveal about the government’s next moves in wound care.Federal Criminal Defense Attorney Ronald W. Chapman IIhttps://ronaldwchapman.com/Safe Harbor Grouphttps://safehg.com/#AuditingAnticsPodcast #Podcast #WoundCareAudits #UPIC #UPICAudits #HealthcareCompliance #MedicalAuditing #AuditReadiness #HealthcareLaw #HealthLaw #ComplianceMatters #MedicalCoding #MedicalBilling #RevenueIntegrity #SkinGrafts #CellularTherapies #CTPs #WoundManagement #HealthcareInvestigations #OIG #CMSAudits #ProgramIntegrity #FraudWasteAbuse #ComplianceLeadership #HealthcareRisk #ProviderEducation #LegalInsights #HealthcareDefense #AuditTrends #WoundCareCompliance #AuditStrategy