Those of you in Ohio and Kentucky received startling news from your Medicare administrative contractor (MAC) – Cigna Government Services (CGS) – last month that examination must always be documented on an established patient E/M note, regardless of the level.If CGS is your MAC and you receive an E/M denial for that reason, mount an appeal, experts say.

Avoid becoming a high-billing practice suspected of inappropriate level 4 and level 5 selection by conducting thorough internal audits of your E/M services. If you have an electronic health records (EHR) system, your physicians are especially prone to improper E/M billing.

Cloned E/M notes on electronic health records (EHR) are one of the top reasons you could be over-billing for E/M levels 4 and 5, and they put you at risk of losing payments in a review. EHR experts see that as a frequent cause of inaccurate and medically inappropriate E/M visit notes created by doctors with good intentions. Even worse, the vendors will frequently promote cloned notes as a product benefit.

Your providers’ $18,000 meaningful use bonuses could be at risk, even if you’ve conducted a security risk analysis (SRA) to comply with HIPAA. While you’re already required to follow security standards for electronic health information, an SRA asks providers to implement security updates and correct security deficiencies as needed.

A final rule implementing new penalties of up to $1.5 million per HIPAA violation could be issued as early as this month, so evaluate how well your practice keeps patient records safe from privacy and security breaches to protect your revenue.

Is there an ICD-9 code to replace code 518.5(Pulmonary insufficiency following trauma and surgery) that was deleted in September 2011?

This chart depicts the percentage of physicians within the selected specialties who e-prescribed in 2011. The data are based on an analysis of nearly 315,000 office-based physicians conducted by Surescripts, an Arlington, Va.-based company that provides e-prescribing services to the health care industry.

With a nationwide physician shortage juxtaposed against the need for organizational growth to bolster the bottom line, hospitals and health systems are constantly, and ­feverishly, trying to fill physician vacancies. However, the "fervor to fill" can create a reactive ­recruiting cycle that may cloud the strategic nature of the hiring process and ultimately result in ill-fated personnel choices. With millions to be gained or lost with each decision, ­creating a ­comprehensive recruitment strategy can help you hire and keep Dr. Right and sidestep Dr. Right Now.

Identifying and recruiting the best physicians is a ­growing concern nationwide. As baby boomer docs start to retire, not only must hospitals replace them, but they must also reinvent their recruitment tactics to reach the younger generation of physicians.

We are about to enter an era of formalized surveys that will finally give patients a chance to talk back to their doctors en masse, to say how they really feel about their office visit experiences. Perceived mistreatment by physicians and their staffs may have a subtle but enormous ­impact on patient compliance, and ultimately on quality and outcomes. And that's why value-based purchasing "satisfaction" scorecards for primary care doctors as well as specialists are just around the corner. Soon these scorecards will be posted on some state health department websites, or on Physician Compare.