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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?
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 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.
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.
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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