$12,910 More Per Year For Health Insurance?
Posted on 13. Feb, 2009 by in Provider News.
Imagine a world where insured patients pay DOUBLE the health insurance premiums they pay now. That reality’s just 7 years away, predicts a recent study from the Public Interest Research Group.
Dollar & Cents: That means average yearly premiums will soar from $11,381 to $24,291 by 2016, reports Business Week.
Bright Idea: Cut health care costs by cutting “red tape” at the insurance companies, suggests PIRG co-author Larry C. McNeely II. “Insurers waste billions each year on paperwork that has nothing to do with patient care,” BW relates. “One suggestion is to limit the amount of premium dollars that can be spent on administrative costs … More …
Make sure you get your patients’ money’s worth from those insurers.
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CCI 15.0 Update for Orthopedic Coders
Posted on 13. Feb, 2009 by in Hot Coding Topics.
Consider Nerve Blocks, Injections Inherent to Most New Ortho Codes — Or Face Denials
Correct Coding Initiative (CCI) version 15.0 has lots of edits for orthopedic codes, but our simple 5-step action plan will steer your orthopedic practice clear of Medicare payback requests for fixation, fasciotomy, and aspiration services.
Step 1: Include X-Rays in Multiplane Fixation Codes
First off, your new multiplane external fixation codes (20696, Application of multiplane [pins or wires in more than one plane], unilateral, external fixation with stereotactic computer-assisted adjustment [e.g.,spatial frame], including imaging; initial and subsequent alignment[s], assessment[s], and computation[s] of adjustment schedule[s]); and 20697 (… exchange [i.e., removal and replacement] of strut, each) did not escape CCI 15.0’s notice.
AUDIO ON DEMAND: 2009 Orthopedic Coding Update with Annette Grady.
Codes 20696 and 20697 include dozens of edits, including many x-ray, CT, and MRI codes. Also, these two new codes will now include:
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Pediatric Billers: SCHIP Enrollment Just Got Easier For Your Patients
Posted on 12. Feb, 2009 by in Provider News.
There’s been quite a bit of hoo-ha over the $32.8 billion State Children’s Health Insurance Program bill President Obama signed this week. What got less attention was a memo he sent to HHS lifting certain SCHIP restrictions from the Bush administration, reports The Wall Street Journal.
SCHIP is meant to be a stop-gap for poor children not eligible for Medicaid. Previously, children had to be 250% below the poverty line to qualify for SCHIP. At $50,000 for a family of four, that’s pretty poor in many places, WSJ notes.
Several states had sued the federal government over the Bush restrictions that Obama’s memo makes null and void, the paper adds.
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CCI 15.0 Update for Radiology Coders
Posted on 12. Feb, 2009 by in Hot Coding Topics.
76942 and 78808 on a single claim needs a second look
43,006. That’s the number of additions Correct Coding Initiative (CCI) 15.0 creates. We’ve got what radiology coders need to know, including the 411 on an edit affecting a new nuclear medicine code.
AUDIO Extra: Back-to-Basics Radiology Coding Course.
This round of CCI, effective Jan. 1, attacks the usual suspects — such as including guidance codes 76942 (Ultrasonic guidance for needle placement …) and 77002 (Fluoroscopic guidance for needle placement…) into a code whose descriptor includes imaging guidance: 55706 (Biopsies, prostate, needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance). CCI also had to create new edits to reflect the changes to the hydration/infusion code digits.
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Audit Hot Spot: Facet Joint Injection Claims
Posted on 12. Feb, 2009 by in Hot Coding Topics.
Here’s why the OIG wants to stick it to facet joint injection claims: Auditors found errors in 71 percent of physician office claims submitted to Medicare in 2006, resulting in $96 million in improper payments, according to a report released last year.
Get your injection coding right on target with Marvel Hammer.
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Cardiology CPT 2009 Crash Course: Device Monitoring
Posted on 10. Feb, 2009 by in Hot Coding Topics.
Our programming eval guide can put your 93279-93285 fears to rest
CPT 2009 is a whole new world for device monitoring, but if you know how to approach the onslaught of new CPT guidelines available, you’ll learn the ropes in no time.
Master your terms: To understand the new “Cardiovascular Device Monitoring — Implantable and Wearable Devices” section of CPT (93279-93299), you have to be sure your understanding of several terms matches CPT’s. For example, to choose among the new code families (consider a family to be a code set with a common start to their descriptors) you will need to distinguish concepts such as programming and interrogation. But within the family itself, you will need to make even more distinctions, such as which technology is involved.
Eliminate the ‘Reprogramming’ Concept for 2009
Start here: The first code family is 93279-93285 (Programming device evaluation with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with physician analysis, review and report …)
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Coder’s Anatomy: What does a knee arthroscopy LOOK like?
Posted on 10. Feb, 2009 by in Hot Coding Topics.
Yes, it’s true. The feds have some goodies that can actually make your day easier.
Say you’re sweating over an op report, and you’re having trouble visualizing what the surgeon did. Help is just a (free) click away at the National Library of Medicine’s A.D.A.M. Encyclopedia.
Just for grins, let’s look at what they have for us coders working on knee arthroscopy notes:
- an image of the procedure
- an image of the anatomy involved
- a description of the procedure
- conditions it treats
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30% of EMR Buyers De-Install Later
Posted on 10. Feb, 2009 by in Provider News.
Suggest this solution and save your practice $45,000 per doctor.
The price tag for an electronic medical records system runs about $50,000 per physician. Yet 30 percent of practices that install EMR drop it later, reports American Medical News.
The problem: Many practices go for deluxe, whiz-bang EMR systems, when ‘lightweight’ EMR might be a better choice … More …
Medicare’s E-Prescribing Program: What’s In It For You?
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Locums Tenens: 11 Ways to Get Paid for Substitute Physicians
Posted on 10. Feb, 2009 by in Toolkit.
You can avoid unnecessary stress during physician vacations when you report reciprocal billing arrangements or locum tenens services. Keep this clip-and-save checklist handy when you apply modifiers Q5 and Q6.
1. Remember that reciprocal billing allows a physician to submit claims and receive Medicare payments for services that he has arranged for a substitute physician to provide on an occasional, reciprocal basis.
2. To appropriately report services a physician performs under a reciprocal billing agreement, use modifier Q5 (Service furnished by a substitute physician under a reciprocal billing arrangement).
3. Locum tenens also allows your radiologist to receive payment for services another physician performs. But a locum tenens physician cannot work for another practice, and your physician cannot restrict the locum’s services to your office.
Want more checklists for Part B rules? Check this out.
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ICD-9 Coding Coach: 530.0, Achalsia
Posted on 09. Feb, 2009 by in Hot Coding Topics.
In a patient with achalsia, the sphincter at the esophagus’ lower end fails to properly relax, and the esophagus distends over time. Achalasia is one of the many motility disorders of the esophagus in which the pressure at the lower esophageal sphincter is abnormally high and does not relax with swallowing.
In advanced achalasia cases, the normal passage of food from the esophagus into the stomach becomes increasingly difficult, and the patient has trouble swallowing.
Other signs & symptoms: Regurgitation of undigested food, chest pain, hiccups, difficulty belching, cough and weight loss.
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