Month: April 2019

Key Questions and Answers for Medicare Voluntary Repayments
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Key Questions and Answers for Medicare Voluntary Repayments

April 24, 2019 In 2016, the government published regulations governing Medicare Part B, addressing the obligation of voluntary repayments. Under the Federal False Claims Act, retained overpayments are punishable by up to three times the amount of the false claim, plus between $11,181 and $22,363 per false claim, creating an effective obligation to “voluntarily” return...

Nine Priority Management Reports to Review Monthly
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Nine Priority Management Reports to Review Monthly

April 17, 2019 We know physicians and managers are busy, but data powers good decision-making. Here are nine priority management reports to review each month. 1. Profit and Loss (P&L) The “P&L” provides a high level view of total revenues and expenses, and indicates how efficiently the practice is being financially managed. The practice’s operating...

How to Respond to Negative Patient Reviews: A Physician’s Guide 
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How to Respond to Negative Patient Reviews: A Physician’s Guide 

April 16, 2019 Negative patient reviews are a fact of life. You can’t avoid them, and you shouldn’t ignore them. Instead, deal with them by leveraging the techniques you’ve honed as a physician – diagnose the problem, synthesize a cure, and administer treatment. In this article, Medical and Dental Justice Founder and CEO, Jeff Segal, MD, JD, shares the essential ingredients...

Diagnosis Code Incompatibility
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Diagnosis Code Incompatibility

April 11, 2019 Question: We are being told by our billing service that “CPT 22551 as the procedure/diagnosis code combination is not compatible” when we use the diagnosis code of M50.11 for an ACDF at C3 -4.  This is the first time that we have ever had an issue with M50.11 for 22551.  Is there...

Separate Procedure Definition
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Separate Procedure Definition

April 11, 2019 Question: What does “separate procedure” mean when it follows a CPT code description? Answer: Per CPT : Some of the procedures or services listed in the CPT codebook that are commonly carried out as an integral component of a total service or procedure have been identified by the inclusion of the term...

Debridement Coding
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Debridement Coding

April 11, 2019 Question: If 10 sq. cm subcutaneous tissue is debrided from the right leg and 20 sq. cm is debrided from the left leg, is it coded as 11042 and 11042-59 or 11042 RT and 11042 LT? Answer: If debridement is performed at the same depth of tissue (all subcutaneous tissue) it is...

E-Consults?
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E-Consults?

April 11, 2019 E-Consults? Question: One of my colleagues told me that she was doing e-consults with other physicians for Medicare and getting paid.  Is this a billable service? Answer: Yes!  Medicare has added CPT codes 99446-99452 for interprofessional/ telephone/internet/electronic health record (EHR) consultations to the fee schedule, so they are now payable services.  These...

Debridement Codes
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Debridement Codes

April 11, 2019 Question: My plastic surgeon debrided an open burn wound that was 45 sq cm then placed a split thickness skin graft over the wound.  Can I report 11042 (debridement skin and subcutaneous tissue, first 20 sq cm) and +11045 (each additional 20 sq cm) for the debridement in addition to the split...

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