Are Online Coding Discussions Putting Your Practice at Risk? Medical Office Manager – October 2018 by Cheryl Toth, MBA Here’s an email we recently saw while monitoring a specialty coding listserv: Subject: Acromioplasty and hardware removal with total shoulder arthroplasty Hello All, We have a surgeon that says I am not an aggressive coder because I...
Category: Coding & Documentation
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Don’t Be the Next Victim of Billing Fraud and Abuse
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...
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2019 CPT® Coding for Skin Biopsies
2019 CPT® Coding for Skin Biopsies ICD10 Monitor – September 2018 by Deborah Grider, CPC, COC, CPC-I, CPC-P, CPMA, CEMC, CCS-P, CDIP Skin biopsy codes are changing. EDITOR’S NOTE: This is the second installment in a two-part series on the 2019 CPT® codes released recently by the American Medical Association. For many years we have used two...
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AMA Releases 2019 CPT® Code Set
AMA Releases 2019 CPT® Code Set ICD10 Monitor – September 2018 by Deborah Grider, CPC, COC, CPC-I, CPC-P, CPMA, CEMC, CCS-P, CDIP New code changes number 335. The new current procedural terminology (CPT®) codes have been released with 335 code changes in 2019. There were many code revisions with guideline, description and instructional note changes. Let’s look...
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Reasons Why Diagnostic Coding Matters in Value-based Care
Reasons Why Diagnostic Coding Matters in Value-based Care AAOS Now – September 2018 by Margaret M. Maley, BSN, MS Payers are great at collecting data. They use the information to develop payment policies, determine reimbursement rates, and, increasingly, to negotiate value-based contracts. Payers profit because they know how much it costs to take care of...
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Protect Your Practice Against Payer Audits with These Preparedness Strategies
Protect Your Practice Against Payer Audits with These Preparedness Strategies Healio ⋅ Orthopedics Today – September 2018 by Cheryl Toth, MBA The top two things that can trigger a payer audit are computer algorithms and coding outliers, according to attorney Patricia Hofstra, a partner at Duane Morris LLC. “It’s almost guaranteed that if you bill a lot...
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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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Tips for Utilizing ICD-10-CM
Tips for Utilizing ICD-10-CM – June 2018 AAOSNow by Sarah Wiskerchen, MBA, CPC In May 2015, most orthopaedic surgeons and their staff were highly focused on learning the new diagnostic language of ICD-10-CM (International Statistical Classification of Diseases and Related Health Problems, 10th revision, Clinical Modification). That’s because the new diagnosis codes were scheduled to...
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Work RVU compensation formulas and surgery modifiers: To discount RVUs or not
Orthopaedics Today – September 2017 by Sarah Wiskerchen 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 creating or negotiating relative value unit-based compensation. Our firm has found there is no...