Find-A-Code Focus Newsletter

2014 November Items

CMS Will Begin Applying the Value Modifier in Calendar Year (CY) 2017 to All Physicians

November 25, 2014
CMS will begin applying the Value Modifier in calendar year (CY) 2017 to all physicians; including those in groups with two or more eligible professionals (EPs), and to physicians who are solo practitioners. This policy completes the phase-in of the Value Modifier to all physicians and groups of phy... Read More

A Practice's Responsibility in Managing Medical Expenses

November 25, 2014
Medical expenses are one of the largest expenses in many United States households. Medical bills and insurance remittance are also possibly the most difficult of all bills for patients to interpret and understand.  Of course, this lack of understanding often has a negative impact on many... Read More

Risk Adjustment, What is it?

November 25, 2014
Risk adjustments are used to compare Actual and Expected Mortality Rates using Risk Adjustments calculated by patient risk score. BC Risk Adjustment — Risk Adjustment 101 WA Regence Administrative Manual  Risk adjustment is part of the Regence Medicare Program Management for Medic... Read More

Conducting a Gap Analysis for Your Documentation & Billing Systems

November 21, 2014
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

Get Ready! Improve your Clinical Documentation!

November 21, 2014
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 Review: Modifier -50

November 21, 2014
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

Business Associates and What To Do If They Refuse To Sign the BAA

November 20, 2014
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

Is it a HIPAA Violation to Email Patients?

November 13, 2014
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

Getting Ready for 2015

November 11, 2014
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

Clinical documentation; Supporting good patient care and proper ICD-10 coding - VIDEO

November 06, 2014
Supporting good patient care and proper coding in an ICD-10 environment.   Speaker Joe Nichols MD presenting training video on Clinical Documentation: (ICD-10 Webinar).... Read More

Is Modifier -59 going away?

November 05, 2014
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

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