16. April 2014

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Tool: Use This Chart To Dispel Security Risk Analysis Myths

HHS OCR gives you a little help on getting your risk analysis down pat. As the HHS Office for Civil Rights (OCR) ramps up its enforcement of the HIPAA Security Rule, you’d better get your compliance in order — and the feds will…

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16. April 2014

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Reader Question: Drill Down to the Correct Bundling Rules

Question:  I used the Correct Coding Initiative (CCI) edits checker tool and entered 2 CPT® codes (58558 and 58559). There was no indication these codes cannot be reported together. However, when I use the CMS scrubber tool and enter the…

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16. April 2014

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Part B Mythbuster: Make Your Global Period X-Ray Claims Picture Perfect

Find out when to apply modifier 76. Myth: X-rays that you shoot or interpret during the global period are not billable to Medicare because payers include these charges in the surgical package.

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16. April 2014

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Reader Question: Let Documentation Guide Your Selection of Principal Diagnosis

Question: A patient was admitted through the Emergency Department with fluid overload. He has ESRD and missed his dialysis last week. The patient also has a history of congestive heart failure (CHF) along with systolic dysfunction and diastolic dysfunction. Now the patient…

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16. April 2014

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ICD-10 Update: President Signs Bill That Includes ICD-10 Delay, Change to 2-Midnight Rule

Plus: Fee schedules stay the same, but physicians seek a permanent SGR formula revision. Physician practices were glad to see that Congress averted the expected 24 percent pay cut that providers were due to fact on April 1, but…

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19. March 2014

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ICD-10-PCS: Follow 3 Steps to Change Your Transplant Coding in 2014

Hint: Focus on allogeneic, syngeneic, and zooplastic to choose the best 7th character. If your facility offers transplant services, then you need to pay attention to the seventh character qualifier of ICD-10-PCS codes. Remember, one misrepresented character could mean the…

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19. March 2014

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Compliance: Keep Your HIPAA Policies In Line By Focusing On 4 Principles

Do your policies set forth clear responsibilities and accountability? Every physician group and facility knows they need compliance and privacy policies in place to keep services on track. But what makes a “good” policy? According to the Malvern Group Incorporated…

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19. March 2014

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Reader Question: Debridement May Be Bundled

Question: Our orthopedic surgeon did a debridement of the labrum along with a rotator cuff repair and decompression and partial clavicle resection. The operative note follows: “There were large bony spurs present on the lateral aspect of the humerus as well…

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19. March 2014

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ICD-10: CMS to Offer ‘End-to-End’ ICD-10 Testing This Summer

The agency intends to select participants by April. You are already aware of the ICD-10 testing period that will launch in just a few weeks, but CMS has even more in-depth system up its sleeve that will ensure that claims…

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19. March 2014

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Inpatient Admissions: Get the Facts on ‘Unforeseen Circumstances’ vs. ‘Exceptions’ to 2-Midnight Rule

Here’s the scoop from the latest CMS provider call. The FY 2014 Inpatient Prospective Payment System (IPPS) final rule gave providers a definition of what constitutes an “appropriate” inpatient admission—when a patient needs to stay at your hospital for over…

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