Auditing Antics: Navigating Medical Coding and Auditing

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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 and billing questions get real-time, audit-focused answers. We’re breaking down E/M leveling, documentation defensibility, payer downcoding, modifier misuse, and high-risk billing patterns before they turn into denials, takebacks, or audit findings.

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 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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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

View our compliance consulting, auditing, and education services here!  https://www.stephanieallardconsulting.com/services

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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

Sign 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-podcast

View our compliance consulting, auditing, and education services here!  https://www.stephanieallardconsulting.com/services

View our Coding Compliance Connection membership here!  https://www.stephanieallardconsulting.com/membership 

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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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Sign 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-podcast

View our compliance consulting, auditing, and education services here!  https://www.stephanieallardconsulting.com/services

View our Coding Compliance Connection membership here!  https://www.stephanieallardconsulting.com/membership 

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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

Sign 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-podcast

View our compliance consulting, auditing, and education services here!  https://www.stephanieallardconsulting.com/services

View our Coding Compliance Connection membership here!  https://www.stephanieallardconsulting.com/membership 

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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

Sign 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-podcast

View our compliance consulting, auditing, and education services here!  https://www.stephanieallardconsulting.com/services

View our Coding Compliance Connection membership here!  https://www.stephanieallardconsulting.com/membership 

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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