What is a Gap Analysis?
A Gap Analysis is a process by which a practice conducts a baseline assessment of the company's coding, billing, operations, and business practices. The objective of a Gap Analysis is to ensure that the practice is in full compliance with applicable legal and ethical require... Read More
It is time to start improving your clinical documentation to prepare your practice for ICD-10.
Select the codes most often used in your practice. Now, you need to determine if your current documentation is sufficient to support ICD-10. It would be best to assume it is not, since ICD-9 was not as sp... Read More
Modifier 50 is used to report a procedure performed bilaterally.
Example: The patient underwent bilateral tympanostomy with insertion of ventilating tubes.
If you look up the CPT code 69433, you will see it is a unilateral procedure and there are instructions telling you to append mod... Read More
Q: Who is a Business Associate and what do we do if they refuse to sign the BAA (Business Associate Agreement)?
A: See the link below, as that will define for you exactly who your business associates would be. When uncertain or in doubt, it is always good to double check the HHS g... Read More
Straight from the Office of Civil Rights:
Q: Does the HIPAA Privacy Rule permit health care providers to use e-mail to discuss health issues and treatment with their patients?
A: Yes. The Privacy Rule allows covered health care providers to communicate electronically, such as through e-mail, wit... Read More
Each new year brings a bundle of surprises in terms of changes and updates that practices must learn and implement. In effort to aid in the preparation of this year, I have listed some common helpful tips that you might follow in order to best manage your workload ahead.
-Evaluate fees: Fee... Read More
Anyone who uses modifier 59 needs to be aware that due to problems with the incorrect usage of this modifier (which by the way is also revised for 2015,) CMS has added four new HCPCS modifiers. An announcement by CMS stated that "CMS is establishing four new HCPCS modifiers to define subsets&nb... Read More
GEMs is a term you will be very familiar with once you start your ICD-10 transition.
General Equivalence Mappings (GEMs) for the ICD-10-CM diagnostic codes were created in a joint effort by CMS and The Centers for Disease Control and Prevention (CDC). GEMs can help you to map codes forwar... Read More
Yes, earned incentive payments will be deducted by 2%; President Obama has required this by law. President Obama issued a sequestration order on March 1, 2013. Under these mandatory reductions, PQRS incentive payments made to eligible professionals and group practices have been reduced by 2%.... Read More