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Vaccine mandate slated to end; prepare for pullbacks, challenges in personnel

05/15/2023

The White House hints that the COVID vaccination mandates for CMS-affiliated health care facilities will soon come to an end. If this removes your legal obligation to have vaccinated staff (note: it may not), make sure you’re ready to make personnel changes in keeping with the new order; if you plan to keep the mandate anyway, prepare for possible challenges.

How to capture the visit when key components drive split/shared billing

05/15/2023

by: Julia Kyles, CPC

Medicare’s rules for split/shared visits allow your care team to use the key components of a facility-based E/M visit to determine who performed the substantive portion of the encounter (PBN 11/14/22). But your physicians and qualified health care professionals (QHP) will need to carefully document each encounter, and your coders will need to review each chart with equal care.

Liability premiums up, again; wring value from carrier extras

05/15/2023

by: Roy Edroso

Brace for some bad news: The AMA says a leading indicator of professional liability premium costs shows them going up. Consider shopping for better prices and avail carrier programs that can save you money.

Implement 6 HIPAA security compliance tips for a strong 2023

05/15/2023

by: Dom Nicastro

HIPAA security remains a hot topic for medical groups, and federal agencies are warning of elevated threats to security. Pay attention to emerging practices that can help keep your data safe — and your money away from regulators.

Report the right E/M level for ED patient with exacerbated chronic illness

05/15/2023

by: Savannah Schmidt

Question: A 19-year-old male with asthma who experienced wheezing and shortness of breath for the past two weeks presented to the emergency department (ED). Inhaler use 10-14 times daily offered temporary relief. Physical exams were normal except for tachycardia, scattered wheezing breath sounds, and elevated respiration. The physician completed three tests (complete blood count; complete metabolic panel; influenza A/B, respiratory syncytial virus, and COVID-19 polymerase chain reaction panel), gave the patient a nebulizer treatment and steroids, released him with MDI and steroid burst, and referred him for a follow-up visit with his doctor of primary medicine. Which CPT code would be reported for this visit?

A year of HIPAA breach data highlights the current threats to PHI

05/15/2023

by: Julia Kyles, CPC

Outside attempts to steal protected health information (PHI), such as ransomware attacks, dominate the headlines, but internal mistakes continue to trigger breaches involving at least 500 patients. Any provider who experiences a breach of that size must file a report with HHS that will be posted on the so-called HIPAA “wall of shame,” notify the affected patients, make a public announcement, take steps to mitigate harm to the patients and, often, weather the bad press that follows.

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