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Assess Whether Acquisition Makes Sense for Your Practice

Assess Whether Acquisition Makes Sense for Your Practice Physicians Practice – February 2019  by Karen Zupko “We said yes because the hospital offered us a ‘sweet deal.'” This was said by a senior surgeon and long-time client who called to report that operational integration had taken a nosedive just a few short months after his practice...

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2019 Billing and Coding Changes for Peripherally Inserted Venous Catheters

2019 Billing and Coding Changes for Peripherally Inserted Venous Catheters SCCM Critical Connections – February 2019  by  Deb­o­rah Grider Central venous access procedures, commonly performed in critical care, have undergone a change in CPT 2019. To qualify as a central venous catheter or device, the tip of the catheter or device must terminate in the...

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Understand CMS Advanced Billing Practitioner Professional Billing

Understand CMS Advanced Billing Practitioner Professional Billing ICD-10 Monitor – January 2019  by Deb­o­rah Grider Not billing the APP service can result in serious revenue cycle errors. Many providers are still struggling with the non-physician practitioner (NPP) billing rules from the Centers for Medicare & Medicaid Services (CMS). Most facilities are now referring to NPPs as...

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Is ‘Insurance Only’ Billing Advisable?

Is ‘Insurance Only’ Billing Advisable? AAOSNow – January 2019  by Cheyenne Brinson and Patricia Hofstra Surgeons instructing billing staff to bill “insurance only” is a scenario that is all too common in orthopaedic practices. In effect, the practice is waiving the patient’s copay, coinsurance, and deductible amounts and accepting whatever amount the insurance company will pay....

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Consider These Questions About Mergers Before You Jump

Consider These Questions About Mergers Before You Jump Orthopaedics Today – January 2019  by Wathen Strong The shift toward hospital or health system ownership of physician group practice has been on a steady pace of growth for several decades. From July 2012 to July 2016, the number of physician practices employed by hospitals increased an astounding...

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Wound Care Coding

Wound Care Coding SCCM Critical Connections – December 2018  by Deborah Grider The wound care (97597-97598) and debridement codes (11042-11047) are used for debridement of wounds that are intended to heal by secondary intention. Some conditions that support medical necessity include infections, chronic venous ulcers, and diabetic ulcers, to name a few. Many insurance carriers, including...

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Scientific Analysis for Medical Liability Claims

Scientific Analysis for Medical Liability Claims AAOSNow – December 2018  by Michael Marks, MD In orthopaedics, as in much of medicine, improvements in patient care are achieved when processes are developed to analyze outcomes. Medical professional liability (MPL) claims can serve as lagging indicators or signals of serious problems in the delivery of care. Medical liability...

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Is Your Practice Optimizing Coding Resources?

Is Your Practice Optimizing Coding Resources? AAOSNow – December 2018  by Sarah Wiskerchen If not, you may be at risk for claim denials or lost revenue Is your billing team or third-party billing service using the right resources, rules, and guidelines when assembling claims and managing denials? When substantiating coding or appealing claims, you must base...

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Answers to Five Common Coding Questions

Answers to Five Common Coding Questions AAOS Now – October 2018 by Margaret M. Maley, BSN, MS and Sarah Wiskerchen What orthopaedic surgeons, practice managers, and staff want to know In this article, we discuss five concerns from surgeons and their staff that are currently “trending.” 1. Vendor advice = a flashing yellow light Question: Our orthopaedic...

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