Archive for the Week of April 7, 2017

Archive for the Week of April 7, 2017

Welcome to the medical billing blog archive for the week of April 7, 2017.

Here you will find links to every article added to the Outsource Management Group web site during the week of April 7, 2017.

You can browse this week's archives by clicking the "More" button from any of the excerpts below.

ICD-11 Beta is available in the trials at WHO

If you are tired of ICD-10, you can go checkout ICD-11 at WHO’s website. ICD-11 Beta is available in the trial stages.     Visit the current version of ICD-11 on the World Health Organization website

By: Melissa Clark, CCS-P, RT - CEO
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5 biggest concerns for health execs in 2017

A new set of concerns has emerged among hospital and health system executives, according to The Advisory Board Company’s latest Annual Health Care CEO Survey. The survey, which was completed by 183 C-suite executives between December and January, found the No. 1 concern among health system leaders in 2017 is improving patients’ access to care in ambulatory or outpatient settings. Last year, this concern was ranked No. 6. An entirely new concern — finding innovative ways to lower expenses — came in at second place. The No. 3 concern was boosting market share for outpatient surgical procedures, up from No. 10 in 2016. “This shift in topic rankings reflects a

By: Melissa Clark, CCS-P, RT - CEO
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Self-service data preparation and analytics

Improving claim collection rates is one way to boost revenue cycle performance, and hospitals can achieve this through various means. Frank Moreno, vice president of product marketing at Datawatch, shared the following tip with Becker’s Hospital Review:”Effective revenue cycle management is only attainable when healthcare organizations have a full view of their patient and operational data. Finance departments cannot wait for IT to provide detailed reports, or spend countless hours manually pulling data from EMRs, 835 and 837 remittance and other files.Yet that’s what is happening at organizations across the country every day. Instead, by using self-service data preparation and analytics solutions, finance teams can easily unlock hidden data to

By: Melissa Clark, CCS-P, RT - CEO
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Who’s Accessing Your Health Data?

Despite the fact that ransomware and hacking attacks draw the biggest headlines, it is actually improper insider access that causes the highest number of data breaches. Such are the results from the most recent Protenus “Breach Barometer,” which analyzes reported and sometimes not so publicly reported breaches in healthcare each month. For those who follow privacy and security in healthcare, the Protenus findings are not that surprising. Reports of inappropriate access by insiders are frequent and show a disturbing trend. Many of the reports allege that information was not used in any detrimental manner. Only that snooping occurred. However, there are two problems with that view. First, even small insider

By: Melissa Clark, CCS-P, RT - CEO
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Making Health IT Safer and Easier to Use

Every day, clinicians work tirelessly to provide the best possible care for their patients. Clinicians and other health care providers like hospitals are increasingly using health information technology (health IT) such as electronic health records (EHRs), and a growing body of evidence shows health IT can help them make care safer. However, new technology can pose challenges and risks. At the Office of the National Coordinator for Health Information Technology (ONC), patient safety is a top priority, and that’s why we maintain the SAFER Guides to help with the implementation decisions clinicians make to reduce EHR associated patient harm. (SAFER is the acronym for Safety Assurance Factors for Electronic Health

By: Melissa Clark, CCS-P, RT - CEO
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Managing HIPAA Risk with Outside Consultants

The rising complexity of healthcare, particularly as it relates to providers’ growing technical needs, is increasingly prompting healthcare organizations to seek the help of outside consultants. In engagements with healthcare entities, thought IT consultants try to minimize interaction with patient data, they often have access to protected health information (PHI). When working with HIPAA Covered Entities, consultants are treated as “business associates” and are required to comply with Privacy Rules designed to protect PHI. Managing HIPAA compliance when engaging outside consultants requires that consultants enter into a Business Associate Agreement (BAA). The BAA must: Describe the permitted and required uses of PHI by the business associate in the context of

By: Melissa Clark, CCS-P, RT - CEO
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Seven Steps to Correctly Code Surgeries

It’s all in how you dissect the operative report. Many coders struggle with coding operative reports because there are so many guidelines and policies that affect code selection. The process is easier when you break it into seven steps: Review the header of the report. Review the CPT® codebook (start in the Index). Review the report/documentation. Make a preliminary code selection. Review the guidelines (for the preliminary codes). Review policies and eliminate the extras. Add any needed modifiers. These seven steps will ensure all the factors that may affect code selection are accounted. Let’s look at an example, and walk through the steps together. Step 1 Review the Header of the

By: Melissa Clark, CCS-P, RT - CEO
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Proper reporting of modifier 99 gets claims paid

Modifier 99 Multiple modifiers doesn’t get a lot of attention — maybe because it’s rarely needed — but knowing when to apply it can make the difference in getting a claim paid. Refer to CPT® Guidance Appendix A — Modifiers tells us: Under certain circumstances 2 or more modifiers may be necessary to completely delineate a service. In such situations modifier 99 should be added to the basic procedure, and other applicable modifiers may be listed as part of the description of the service. In practice, call on modifier 99 only if a single line item requires five or more modifiers. The reason is the standard 1500 Health Insurance Claim

By: Melissa Clark, CCS-P, RT - CEO
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