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6 steps to protect your practice when a patient’s attorney requests records

07/02/2018

The recent news reports that three men claiming to represent President Donald Trump, including an attorney from the Trump Organization, raided the medical offices of Trump’s long-time personal physician and took Trump’s records is a good reminder that third parties don’t have an automatic right to patient records even when they say they do.

Outside of E/Ms, surgical team and injections, NPPs have denial trouble

07/02/2018

by: Roy Edroso

Non-physician practitioners (NPPs) have lower-than-average denial rates on E/Ms, but our analysis suggests they have trouble with other types of codes.

Check all employees monthly – and try different name spellings – to avoid exclusion hassles

06/26/2018

by: Roy Edroso

Despite an apparently simple process, provider exclusions get missed all the time, costing practices a fortune in claims takebacks and penalties. To avoid this, set up a process, check everybody and sweat the details.

Adopt standalone EHR training to save providers precious time

06/25/2018

by: Richard Scott

Investing in additional training for your electronic health record (EHR) can significantly improve your providers’ efficiency with the technology and reduce the taxing effect of lag time that can cut into your revenue stream.

Follow AHA Coding Clinic’s advice for marijuana, prescription opioid use

06/25/2018

by: Julia Kyles

As more states legalize the use of marijuana, you may see documentation of recreational marijuana use by patients. But don’t code it unless the clinician documents a problem associated with the drug’s use, according to the American Hospital Association’s (AHA’s) Coding Clinic second quarter guidance.

Conduct a mid-year MIPS check-up of your clinicians’ quality efforts

06/25/2018

by: Julia Kyles

It’s halfway through the reporting year for the quality portion of the merit-based incentive payment system (MIPS). If clinicians at your practice are reporting quality via claims, this is a good time to take stock of how they’re doing.

Dig into the CCI manual for guidance on ear wax removal, new patient visits

06/25/2018

by: Julia Kyles

Question: The CCI edits bundle established patient visits (99211-99215) into the ear wax removal procedure. Per this explanation, I would expect a CCI edit for new patient visits, but I don’t sae them. Can you explain why the edits are not in the code set?

Check the discharge: TCM claims should be backed by the inpatient discharge record

06/25/2018

by: Julia Kyles, CPC

Practices that perform transitional care management (TCM) services (99495-99496) should work with inpatient facilities to confirm the date a patient was discharged. The documentation for TCM services should include the date the patient was discharged from an inpatient facility, such as a hospital or skilled nursing facility. However, a comparative billing report performed last year found that some TCM claims did not have a matching discharge record from the facility.

06/25/2018

Have a question about the physician practice environment that you’d like to run by your peers? You can now tap into the expertise of your colleagues, as well as the editorial team of DecisionHealth, the publisher of Part B News, with two practice-focused forums.

CCI version 24.2 edits place caps on new therapy code, free up obesity counseling

06/18/2018

by: Richard Scott

Incorporate updated billing limits on specific counseling and therapy codes to avoid running afoul of the latest Correct Coding Initiative (CCI) guidance. Effective July 1, CCI version 24.2 edits target specific services that practices report hundreds of thousands of times per year.

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