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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

Published By: Melissa Clark, CCS-P on April 5, 2017

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

Published By: Melissa Clark, CCS-P on April 4, 2017

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

Published By: Melissa Clark, CCS-P on April 3, 2017

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

Published By: Melissa Clark, CCS-P on April 3, 2017

Anthem-Cigna deal could improve competition

Three judges heard appellate arguments from Anthem on March 24, as the insurer pled its case against a district court’s ruling blocking its merger with Cigna, Bloomberg BNA reports. Here are four takeaways from the hearing. 1. One judge in the U.S. Court of Appeals for the District of Columbia Circuit said if Indianapolis-based Anthem’s merger with Bloomfield, Conn.-based Cigna led to $2.4 billion in medical cost savings for consumers, as the insurer has argued, it could be beneficial. “That seems like an improvement in competition and consumer welfare,” U.S. Circuit Judge Brett Kavanaugh said, according to the report. Anthem has said a merger with Cigna would allow the resulting

Published By: Melissa Clark, CCS-P on March 31, 2017