Month: September 2017

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Work RVU compensation formulas and surgery modifiers: To discount RVUs or not

Work RVU compensation formulas and surgery modifiers: To discount RVUs or not Orthopedics Today – September 2017 by Sarah Wiskerchen, MBA, CPC In hospital employment settings, as well as large groups, work relative value unit-based compensation agreements and formulas are often standard. Understanding how work relative value units are credited is an essential element of...

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Is Telemedicine the Future of Healthcare?

Is Telemedicine the Future of Healthcare? Understanding the Reporting Requirements for Telemedicine Services – September 2017 by Deborah Grider, CPC, COC, CPC-I, CPC-P, CPMA, CEMC, CCS-P, CDIP EDITOR’S NOTE: National Quality Forum (NQF) issued two new reports this week that provide guidance to advance health information technology, with the intent of making healthcare more effective and...

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Telehealth at a Tipping Point

Telehealth at a Tipping Point – September 2017 By: Betty A. Hovey, CCS-P, CPC, CPMA, CPCD, and Cheryl Toth, MBA What’s a service orthopaedic practices can offer that is popular with patients, reimbursed by most payers, not too expensive to implement, and deliverable in all 50 states? Telehealth: Although it’s obviously not suitable for every...

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Top 10 HIPAA Mistakes for Practices to Avoid

Top 10 HIPAA Mistakes for Practices to Avoid – September 2017 By: Michael R. Marks, MD, MBA, and Michael Sacopulos, JD The Health Insurance Portability and Accountability (HIPAA) Act of 1996 continues to challenge every medical practitioner. A recent discussion on the current state of HIPAA revealed the top 10 mistakes that practices make during...

When can I code an adrenalectomy?
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When can I code an adrenalectomy?

September 7, 2017 Question: I performed a laparoscopic adrenalectomy with a urologist who performed a laparoscopic radical nephrectomy. Do I code 60540 for the adrenalectomy? Answer: No, you are acting as a co-surgeon, since there is a CPT code that describes both your work and the work of the urologist. Code 50545-62 would be reported...

Billing “Incident to”
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Billing “Incident to”

September 7, 2017 Question: Whose NPI number do we bill under when a PA sees the patient in the office under the “incident to” rules for Medicare?  We bill under the NPI number of the physician who is assigned to the PA.  Is that correct? Answer: No, when billing “Incident to,” bill under the NPI...

Post-Op hemorrhage repair. Is it billable?
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Post-Op hemorrhage repair. Is it billable?

September 7, 2017 Question: Can I bill for taking the patient back to the OR to explore and repair post-op hemorrhage on day post-op? I heard that all complications are included in the payment of the original surgery. Answer: Yes, you may bill for this.   CPT and Medicare agree that taking the patient back to...

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