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Practice Management Alert

Compliance:
Notify Secretary of Breaches to Stay HIPAA-Compliant
Experts: Be sure you show HHS how you’ve improved defense of sensitive info. Whe... Read more
Compliance:
FAQ: Submit Breach Media Notices on Time to Satisfy Secretary
Remember, definitions of ‘media outlets’ depend on your locale. Dealing w... Read more
Coding:
Rely on Modifier 25 to Procure Separate E/M Payment
E/M-25 service must exceed E/M built into procedure code. If your physician performs a... Read more
You Be the Expert:
Choosing the Proper Physical Code
Question: We are starting to get appointment requests from patients reporting for p... Read more
Reader Questions:
Know What You Need Before Calling Locum Staffers
Question: We have a physician that is taking a six-month sabbatical soon, and we ne... Read more
Reader Question:
Be Mindful of Everyone on Holiday Décor, Parties
Question: We are a large practice with more than 30 employees. With the holidays co... Read more
Reader Question:
CMS Says ICD-10 Already Paying Off
Question: Since the ICD-10 implementation on October 1, we have been doing our best... Read more
Reader Question:
Test EHR Functionality Frequently Post-Implementation
Question: What should our practice do to prevent unintended consequences from elect... Read more
E/M Coding:
Use New/Revised E/M Codes for Prolonged Services
CPT® 2016 recognizes ‘team’ E/Ms, psychotherapy. There aren’t ma... Read more
Primary Care:
Now Hear This: Use New Code for 'Standard' Cerumen Removal
Lavage/irrigation get their own code in 2016. Physician practices that perform cerumen... Read more
Otolaryngology:
Choose From Pair of Codes for 'Balance' Tests in 2016
Sinus implants also get a bump with a pair of ‘T’ codes. Physician practic... Read more
Clip and Save:
Use This Chart to Keep Track of New Surgical Codes
If your practice performs these surgeries, keep this chart handy. The CPT® 2016 ma... Read more
You Be the Expert:
Make OB Panel, Fetal MRI Part of Your 2016 Coding Repertoire
Question: We had an all-staff meeting at our OB-GYN office last week. Our director ... Read more
Reader Question:
Look for 2016 Changes to Cholangiography, Biliary Drainage
Question: I work at a small, rural general surgery practice. We have a coder on sta... Read more
Reader Question:
Use These New Category I Codes, Ditch Some Cardio 'T' Codes
Question: Our cardiology practice has been keeping a close eye on the American Medi... Read more
ICD-10:
Start Second Phase of ICD-10 Training After Oct. 1
Coders, clinicians must come together to solidify office’s ICD-10 coding. For ma... Read more
ICD-10:
Don't Worry, Be Happy about ICD-10?
Here’s one expert’s tips on reducing ICD-10 stress. With all the drama sur... Read more
ICD-10:
CMS Releases FAQ to Explain 'Grace Period,' Cement Start Date
Be ready to use ICD-10 Oct. 1, or claims won’t fly. Amid the ocean of informatio... Read more
You Be the Expert:
Choosing the Correct CRPS Code
Question: What diagnosis code should we report for chronic regional pain syndrome (... Read more
Reader Question:
Get on Board with New Diabetes Dx Differences
Question: Our pediatric practice sees patients with both type I and type II diabete... Read more
Reader Question:
Exercise Caution with 'Other' ICD-10s
Question: If I find that a common ICD-9 code that I use doesn’t have a direct... Read more
Reader Question:
Remember Metastasis Code in Addition to Primary Tumor Dx
Question: During radiological assessment in a patient with prostate cancer, our phy... Read more
Reader Question:
Mind Dx on Short Interval Between Pregnancies Services
Question: Is there a diagnosis code to use for short interval between pregnancies? ... Read more
Reader Question:
Look to H61.2x For Cerumen ICD-10 Dx
Question: Which code will replace 380.4 (Impacted cerumen) under ICD-10? Wisconsi... Read more
Compliance:
Ferret Out Potential PHI Violations, Get Ahead of Notification Curve
Feds expect you to notify everyone affected by every HIPAA breach. When you’re f... Read more
Compliance:
Avoid 7-Figure HIPAA Violation Penalties
Worst-case scenarios could cripple your practice with federal fines. If you fail to pr... Read more
E/M Coding:
Keep Accurate ROS Count To Make Correct E/M Decision
Spot complete ROS and you might be able to code a high-level E/M. When you’re c... Read more
Clip 'n Save:
Form Your HIPAA Breach Notifications Around This Template
Avoid fines for lax notification, which start in five figures. If a Health Insurance P... Read more
You be the expert:
E/M Or Eye FBR?
Question: An established patient who was shooting off fireworks the previous day re... Read more
Reader Question:
Make Sure Your Documentation Is In Order On Modifier 52 Claims
Question: We recently submitted a claim for reduced services because the physician ... Read more
Reader Question:
Aetna Makes Several Software Recommendations Ahead of ICD-10
Question: We’ve gotten a lot of guidance on how Medicare wants us to prepare ... Read more
Reader Question:
Tailor Practice Manager Description To Your Practice's Needs
Question: I am an assistant at a small medical practice that has expanded to the po... Read more
Medicare Compliance:
Ensure Proper Payment With ABNs For Potentially Uncovered Services
ABN protocols can have residual effects on patient relations. As difficult as it might... Read more
Clip 'n Save:
Keep This Table Close To Aid ABN-Related Modifier Choice
Medicare also has modifiers for when you aren’t obligated to provide an ABN. Whe... Read more
E/M Coding:
Put Time On Your Side When Choosing Observation Codes
Codes differ for single-, multi-day stays. Coding for your physician’s observati... Read more
Compliance:
Take 8 Steps Toward Tripping Up Medical ID Thieves
Beneficiaries, practice employees are potential targets. A Medicare beneficiary can qu... Read more
What Would You Do?:
Choosing New vs. Established Patient Codes
Question: What is the difference between a new and established patient, for office ... Read more
Reader Question:
MACRA Puts Auto-Renew On Medicare Opt-Outs
Question: Our surgery practice has chosen to opt out of Medicare. I heard that there&rsq... Read more
Reader Question:
CMS Confirms ICD-10 Start... With Some Permissive Alterations
Question: Has there been any news on the ICD-10 implementation? We feel like we’re... Read more
NPP Billing:
Follow Incident-To Rules, Collect More Cash
If you aren’t using this billing technique, your practice may be losing 15 pe... Read more
Physician Billing:
Observe Locum Tenens Terms, Say 'Bon Voyage' to Claims Concerns
Remember: You can’t bill locum tenens for ‘extra help.’ Summer&rsquo... Read more
Payer Policies:
Knowing These Tricare Rules Is Half of the Billing Battle
Tip: Consider military insurer secondary in most cases. Odds are your practice will se... Read more
What Would You Do?Billing for 'Welcome to Medicare' Encounters
Question: I’ve recently taken on some coding/billing duties while our lead co... Read more
Reader Questions:
Consider 'Impairment Testing' In Place of Random Drug Screens
Question:  Our practice has not performed any type of employee drug screening in th... Read more
Reader Questions:
Medicare Paves 'Road' to ICD-10 Readiness
Question: Our entire office is pitching in to prepare for the switch over to ICD-10 diag... Read more
Reader Questions:
Identify PMFSH to Aid E/M Level Choice
Question:   I have a claim in front of me that is giving me pause because I ca... Read more
Reader Questions:
Check OIG's Mid-Year Update to Keep Compliant
Question: A fellow practice manager recently told me that the Office of Inspector G... Read more
Coding News You Can Use:
Stop Searching for X Modifier Clarification From CMS - For Now
CMS reps say you can stick with modifier 59 for the time being. When new coding direct... Read more
Compliance:
Bust 10 Compliance Myths to Keep Your Practice On the Up and Up
Don’t fall victim to these misconceptions that could cost your practice. As a pr... Read more
Clip and Save:
Ensure HIPAA Compliance with 7 EHR Development Questions
Don’t stop with security checks.  With more and more practices moving to el... Read more
What Would You Do? Modifiers vs. ICD-10 Specificity
Question: I have heard the ICD-10 codes are expanded and more specific than ICD-9 c... Read more
Reader Questions:
Stick to Most Definitive ICD-10 Code
Question: Though there are many crosswalks between ICD-9 to ICD-10, there are many ... Read more
Reader Questions:
Step Up Your Multi-tasking Ability
Question: As a practice manager I have a lot of different tasks to juggle in a day.... Read more
Reader Questions:
Consider Patient Satisfaction in New vs. Established
Question: If one of our family physicians referred a patient to one of our nurse pr... Read more
Reader Questions:
Stay Secure with Both 'Patches' and 'Updates'
Question: Are “patches” and “updates” to computer software ... Read more
News You Can Use:
Say Goodbye to SGR Patches
At press time, the President still needed to sign the bill in to law.  Although A... Read more
Payer Pointers:
Clear Up 6 Common Coding Misconceptions With Advice Direct From NGS
Watch for errors with MDM, X{EPSU}, PQRS, and more. Still looking for modifiers X{EPSU... Read more
Office Security:
Protect PHI on Your Providers' Mobile Devices
Don’t stop with passwords. Smartphones, tablets, and laptops are commonplace in ... Read more
What Would You Do? :
Uncover Reasons for Employee Tardiness
Question: We have a member of the office staff who is late to work fairly often. Sh... Read more
Reader Questions:
Identify 'Request for Opinion' Before Choosing Consult
Question: A new patient came to see a neurologist in our practice to discuss whether she... Read more
Reader Questions:
Documentation is Key to Preventive + Problem-Oriented Coding
Question: Our internist recently saw a patient for his routine physical examination... Read more
Reader Questions:
Stick to Most Definitive ICD-10 Code
Question: Though there are many crosswalks between ICD-9 to ICD-10, there are many ... Read more
Stark Law Case Study:
Beware of Stark Pitfalls Affecting Your Professional Service Arrangements
Keep contracts clear and detailed to help avoid penalties. Working with other provider... Read more
HIPAA:
Follow 5 Steps to Stay HIPAA Compliant in 2015
Don’t expect fewer audits this year.  HIPAA continues to be at the top of e... Read more
ICD-10:
Sign Up Now to Test Your Practice's ICD-10 Readiness
Determine which testing option is best for your providers. You don’t want to be ... Read more
What Would You Do?:
Check HIPAA Pitfalls Before Texting
Question: Some of our providers are interested in the cutting edge use of technology in ... Read more
Reader Question:
Focus on Payer Rules Governing 51 Use
Question: I have heard our coders saying that they don’t need to attach modifier 5... Read more
Reader Question:
Watch 'Other Qualified Healthcare Professional' Pitfall
Question:  One of our psychologists in our practice is insisting on using E/M codes... Read more
Reader Question:
Different Specialties Can Justify Multiple E/Ms
Question: I work in a practice that has multiple specialties, including internal medicin... Read more
NPP Language:
Focus on Terminology to Navigate the NPP Maze
Take note of an NPP’s background to best take advantage of her skills. The first... Read more
Coding Corner:
Mix and Match 1995 and 1997 for E/M Leveling
Review a clinical scenario to drive the point home. Evaluation and management (E/M) co... Read more
Payer Focus:
Review Palmetto's Top 5 Most Common Denial Reasons So You Can Avoid Them
Use this list to see where your practice might fall short. There are countless reasons... Read more
Compliance:
Clean Up Your Duplicate Claims Before You Make the RAC Hit List
Knowing the reason for the denial is your key to successful appeals. Curious about whi... Read more
What Would You Do?:
Mitigate HIPAA Risk at the Front Desk
Question: I was at my own PCP office and when I went to stand at check in, there wa... Read more
Reader Question:
Protect Against Both Viruses and Malware
Question: Does our practice need to have both antivirus and antimalware software? W... Read more
Payer Relations:
Get the Lowdown on What to Look for During Successful Payer Contract Negotiations
Pay attention to eight key points in the fine print. While contracts don’t have ... Read more
Reimbursement:
Rejoice in Minimal CF Changes--For Now
Stay tuned for changes in April. For the first time in several years, your practice di... Read more
Compliance:
Ensure ACA Compliance with 7 Strategies Straight From the Experts
Start the process before CMS enforces the ACA requirements. You know you need a compli... Read more
Follow This Compliance Director's Advice
As you use Dr. Taitsman’s advice to create a compliance plan, keep the following q... Read more
What Would You Do?:
Patient Not Present -- To Bill or Not to Bill?
Question: There is some confusion in our pediatric practice on how to submit a clai... Read more
Reader Question:
Upfront Collection is a Per-Practice Decision
Question: Our practice is considering collecting deductibles upfront if a patient n... Read more
Reader Question:
Update Your Forms to Include Technology
Question: Should we develop some sort of consent form for patients to sign if they ... Read more
Reader Question:
Check V84.01 Coverage Before Screening MRI
Question: We have a Medicare patient that is BRCA2 positive. Our doctor wants to sc... Read more
Billing Primer:
Define 'New Medical Condition' For Proper Incident-To Billing
Remember that not all payers follow the same rules. While incident-to billing can boos... Read more
Physician Pointers:
Change Your Providers' Thinking on ICD-10
Overcome provider concerns with these six tips. If your physicians are focused on the ... Read more
Reimbursement Roundup:
Prep for Upcoming Global Period Changes
Drastic coding changes will put you on the auditor target list. If you were hoping tha... Read more
What Would You Do?:
Get to Know HIPAA Rules for Same-Sex Marriage
Question: I heard there was a recent ruling that affects how we view HIPAA for pati... Read more
Reader Question:
Combat Flu in Your Office
Question: This time of year we have several people in the office getting sick, espe... Read more
Reader Question:
Planning Ahead Means Solid Candidates
Question: I was just put in charge of recruiting and hiring two new office employee... Read more
Reader Question:
Clear Up Patient Medicare Confusion
Question: We have a patient asking why she has to pay anything when we accept assig... Read more
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