Don’t Be the Next Victim of Billing Fraud and Abuse AAOS Now- October 2018 By: Michael R. Marks, MD, MBA Every physician has scenarios they seek to avoid: bad nights on call, less than optimal outcomes, and the fear of malpractice suits. What many don’t think about are coding mistakes that could result in federal...
Author: Michael Marks (Michael Marks)
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Have You Heard the Latest Professional Liability Risk?
Have You Heard the Latest Professional Liability Risk? AAOS Now- June 2018 By: Michael R. Marks, MD, MBA HIPAA allows states to recognize cause of action for breach of confidentiality The list of liability risks for physicians continues to increase. On behalf of the Medical Liability Committee, this article presents new risks via highlights from...
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Are Physicians Required to Return Overpayments?
Articles Are Physicians Required to Return Overpayments? Michael R. Marks, MD, MBA Michael Sacopulos, JD AAOS Now – May 2018 When overpaid, many providers wonder if they need to return the funds. The short answer is yes. An overpayment is money that does not belong to providers and keeping it exposes them to collection and...
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Arthroscopy Coding for Major Joint – Shoulder
Articles Arthroscopy Coding for Major Joints – Shoulder Michael R. Marks, MD, MBA AAOS Now – March 2018 An accurate understanding of coding rules increases likelihood of receiving appropriate paymentCorrectly reporting and billing for arthroscopy services is often confusing. Last month, AAOS Now reviewed the knee arthroscopy codes and outlined the appropriate use of modifiers. This...
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Arthroscopy Coding for Major Joints – Knee
Arthroscopy Coding for Major Joints – Knee AAOS Now – February 2018 By: Michael R. Marks, MD, MBA When the American Medical Association (AMA) published the first edition of Current Procedural Terminology (CPT) to standardize surgical procedure terminology and reporting, modern arthroscopy was in its infancy and no CPT code described it. As the number...
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Have You Heard the Latest Medical Liability Risk?
Have You Heard the Latest Medical Liability Risk? AAOS Now – January 2018 By: Michael R. Marks, MD, MBA and Daniel R. Schlatterer, DO, MS Court rules that surgeons must personally deliver informed consent On June 20, 2017, the Commonwealth of Pennsylvania Supreme Court handed down a 4–3 decision that has the potential to rock the world...
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Medical Imaging and HIPAA Compliance
Medical Imaging and HIPAA Compliance AAOS Now – October 2017 By: Michael R. Marks, MD, MBA What orthopaedic surgeons need to know Last month, I coauthored an article on Health Insurance Portability and Accountability Act (HIPAA) compliance that offered tips on how orthopaedic practices can keep their patients’ information safe (see “Top 10 HIPAA Mistakes...
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Is Your Practice Not Getting Paid?
AAOSNow – July 2017 by Michael R. Marks, MD, MBA, and Cheryl Toth, MBA Coding May Not Be the Reason It’s easy to blame a practice’s skyrocketing accounts receivable (A/R) on coding and the insurance companies. But our experience with orthopaedic practices, and the results of AAOS/KarenZupko & Associates (KZA) pre-workshop surveys on coding and...
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CPT 2017 for Foot and Toes
AAOS Now – January 2017 by Michael R. Marks, MD, MBA Every autumn, the American Medical Association’s (AMA) Current Procedural Terminology (CPT) book is updated with changes for the next year. In 2016, minimal changes were made, possibly due to the implementation of the International Classification of Diseases, 10th edition (ICD-10) and a desire to...
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7 Golden Rules for Reducing Hip Arthroscopy Denials
AAOS Now – December 2016 by Michael R. Marks, MD, MBA If a constant stream of denials for hip arthroscopy procedures frustrates you, know that you are not alone. These denials are a common source of angst for physicians. The good news is, if you know how to avoid common coding pitfalls, document correctly, and...
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