Category: Art-Orthopaedics

Are Physicians Required to Return Overpayments?
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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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What is in that alphabet soup? Deciphering coding acronyms to support reimbursement

Articles What is in that alphabet soup? Deciphering Coding Acronyms to Support Reimbursement Sarah Wiskerchen, MBA, CPC Healio Orthopedics • Orthopedics Today January 2018 The physician’s role in the revenue cycle is important for optimizing charge capture in independent and employment settings. Understanding key acronyms related to code sets and reimbursement guidelines is important to...

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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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Dispensing DME in Orthopaedics for Medicare

Dispensing DME in Orthopaedics for Medicare – November 2017 AAOSNow by Sarah Wiskerchen, MBA, CPC  Answers to key coding questions Orthopaedic practices often provide patients with supplies, such as casts and canes, integral to patients’ treatment plans. This article covers the essentials of coding and claims submission. Understanding the definitions and rules for DME can...

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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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Six Steps for Conducting an Internal Evaluation & Management Audit

Six Steps for Conducting an Internal Evaluation & Management Audit Healio Orthopedics • Orthopedics Today – September 2017 by Sarah Wiskerchen, MBA, CPC Evaluation and management coding patterns are under the microscope. CMS is monitoring evaluation and management code usage by specialty, state and nationally. The Recovery Audit Program of CMS aims to identify and correct...

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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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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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