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After Meta pixel HIPAA gaffe, check your online business associate agreements

07/11/2022

An expose caught major health systems kicking patient data to Meta, Facebook’s parent company, via their online appointment page. The exposure of patient data may have you wondering: Are my online services doing the same thing and, if they are, are my business associate agreements (BAA) protecting me?

AMA unveils anticipated E/M changes for facility-based services

07/11/2022

by: DecisionHealth Staff

The AMA set off its own fireworks during the Independence Day weekend with the early release of new E/M guidelines that will be included in the 2023 CPT manual and take effect Jan. 1, 2023.

OIG finds PBDs overpaid for E/M services; CMS disinclined to act

07/11/2022

by: Roy Edroso

OIG has found, through extrapolated data, that provider-based departments (PBD) in hospitals that bill outpatient E/M encounters are getting more generous reimbursement than freestanding clinic providers who perform them. But it appears the chances that anything will be done about it anytime soon are slim.

Deconstruct ICD-10-CM guidelines for selecting a primary diagnosis code

07/11/2022

by: Holly Cassano, CPC, CRC

From my experience of over 25 years in the industry, I’ve noticed that one of the most challenging aspects of documentation review is accurate identification of a primary diagnosis. The primary diagnosis describes the most time-consuming or resource-intensive problem during an encounter.

In 2020, modifier 78 use less frequent, and much less successful

07/11/2022

by: Roy Edroso

Use of modifier 78 (Unplanned return to the operating room by the same physician following initial procedure for a related procedure during the postoperative period) has been in decline for some time. In 2020, as COVID depressed utilization across the board, 78’s claim numbers continued to decline — while its denial rates soared.

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