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Practice Management Alert

Collections:
Know When, and How, to Get Tough With Nonpaying Patients
Here’s why experts say that ‘hard’ collection should be a last resort.... Read more
Office Décor:
Brighten Patient's Day With Smart Lighting Choices
If you think your choice of lighting doesn’t matter, think again. Setting just t... Read more
Procedure Coding:
Carve FBR Evidence From Claim Before Choosing Code
Careful, that splinter removal might be an E/M service. Let’s say your physicia... Read more
You Be the Expert:
Deciphering Observation Denials
Question: We recently submitted a 99236 code for an observation service our physici... Read more
Reader Question:
Keep Things Inclusive for Happy Holidays
Question: Could you offer some tips on how we should handle holiday decorations in ... Read more
Reader Question:
I.D. Type of Telemedicine Before Coding
Question: Often, one of our physicians or qualified nonphysician practitioners (NPPs) pr... Read more
Reader Question:
Use These Tips, Pump Life Into Your CPR Coding
Question: What are the time requirements associated with CPT® code 92950? Haw... Read more
Office Management:
Use These Tips to Balance Waiting Area Amenities, Patient Comfort
Expert: Free-flowing traffic patterns a must for waiting areas. Every medical practice... Read more
Office Management:
Set the Proper Tone in Waiting Area With Soft Colors
Chair material can also impact patient’s practice experience. When you have the ... Read more
E/M Coding:
Note These Rules to Make Proper Observation Code Choice
Experts: Check with third-party payers on longer one-day stays. Coding for your physic... Read more
E/M Coding:
Make Documentation Priority 1 for These Observations
Expert: When observation stay goes beyond the pale, payer will have questions. Most o... Read more
You Be the Expert:
Coding for Hernia Repairs
Question: Encounter notes indicate that an adult patient presents to the surgeon fo... Read more
Reader Question:
Check Out the New Dx Code for Zika
Question: Is there an ICD-10 code for the Zika virus in the 2017 update? Maryland... Read more
Reader Question:
Get Hip to Differing Types of PHI
Question: I’m pretty sure I know what types of information constitute protect... Read more
Reader Question:
Prevent Federal Headaches By Obeying Stark Law
Question: I overheard one of our nurse practitioners (NPs) say that someone at the ... Read more
Accounts Receivable:
Take These Tips to Heart, Catch Up on A/R
Here’s why you need an administrator to conduct regular A/R reviews. Some practi... Read more
Employee Evaluations:
Look Forward While Discussing Past In Performance Reviews
Experts: A portion of all reviews should be about the future. Tensions can run high wh... Read more
Quick Tips:
Use This Advice to Start Your Evaluation Forms
Here’s why an expert recommends tailoring your evaluations to each job. Before c... Read more
You Be the Expert:
Coding PT vs. Chiropractic Services
Question: We are a local chiropractic practice that often receives referrals from l... Read more
Reader Question:
Look At 5 'W's' for CPPM® Guidance
Question: We are formulating our budgets for training and certifications for 2017, ... Read more
Reader Question:
Get Individual Breach Notifications Right to Avoid Penalties
Question: We have had a couple of individual breaches of the Health Insurance Porta... Read more
Reader Question:
Get Creative to Keep Top Performers Happy
Question: In the past year, we have lost two of our best coders and one of our best... Read more
Compliance:
Get BAA If Entity Has to Comply With HIPAA
Remember, not everyone who accesses PHI has to sign BAA. When you’re working wit... Read more
Time-Based Coding:
Know Counseling Exception, and Time Is On Your Side
Experts: Include documentation noting counseling/coordination time. If you are coding ... Read more
Time-Based Coding:
Check Out These Counseling Exception Scenarios
Discussing test results, diagnoses often result in time-heavy E/Ms. While there are no... Read more
You Be the Expert:
Coding For Sunburned Patients
Question: This summer, our practice has seen an overflow of sunburn patients. When ... Read more
Reader Question:
Master 7th Character, X Placeholder to Hone ICD-10 Skills
Question: I’m still getting the hang of using the ICD-10 coding system, but I... Read more
Reader Question:
Appeal to Company Reps to Up Patient Enrollment
Question: I am working at a practice that is just starting to see clients in a new ... Read more
Reader Question:
Put Locum Docs on the Clock
Question: We have to hire a locum tenens (LT) physician for one of our providers wh... Read more
Patient Relations:
Use This Framework When Forming Patient Termination Policy
If you have to end relationship with patient, certified mail is your best friend. Brea... Read more
Patient Relations:
Check Out These Top Reasons for Ending Patient Relationships
Unpaid bills, difficult patients among possible termination factors.  No medical... Read more
E/M Coding:
Follow This Advice to Grab Concurrent Care Pay
First step: Be sure your provider isn’t duplicating another’s service. Wh... Read more
CPT® Modifiers:
Use Modifier 26, Snag Your Provider's Portion of Service
If the equipment’s not yours, you might need this modifier. Medical practices of... Read more
You Be the Expert:
Plugging Coding Holes on Your Nosebleed Encounters
Question: When our physician stops a nosebleed, should we report a CPT® evaluat... Read more
Reader Question:
Gather Details Before Deciding Patient Status
Question: An intensive care physician asked my pediatrician to see a premature newb... Read more
Patient Relations:
Put Patients at Ease With a Relaxed Reception Area
Cleanliness is next to godliness in the places your patients wait. You can’t mak... Read more
Patient Relations:
Tailor Reception Area to Patient Population
What works in a pediatrician’s office might not be appropriate for other specialti... Read more
Medicare News:
Medicare Ruling On JW Modifier Could Boost Bottom Line
Feds: Use JW for some discarded drugs. If your practice loses money on discarded drug... Read more
CCI:
New Edits Make INR, Anticoagulation Part of Hospital Codes
Here’s the trio of codes you should stop reporting with inpatient E/Ms. The late... Read more
You Be the Expert:
Spotting Evidence of 'Intractable' Migraines, 'Status Migrainosus'
Question: I do some light diagnosis coding when we are short-staffed and I have the... Read more
Reader Question:
Tighten Up Risk Assessment Practices in Case OCR Comes Calling
Question: In addition to being the practice manager, I’m also part of our ris... Read more
Reader Question:
Use Z Codes As Primary Dx -- Sometimes
Question: In our practice, we’re still getting used to the intricacies of the... Read more
Reader Question:
Implement These Basic Measures, Keep PHI Hackers at Bay
Question: In the past year, we have had to deal with several Health Insurance Porta... Read more
Patient Relations:
Use Conversations, Online Tools to Gauge Patient Satisfaction
Get the most out of patient input by offering feedback options via several methods.... Read more
Scheduling:
Keep Schedule Full With Cancellation Plan
Even a couple of unfilled appointment slots could cost thousands. When a patient calls... Read more
Training:
Get Staff on Board Before Floating Cancellation Solutions
Without everyone in the practice on board, your protocols might not work. There are se... Read more
Clip & Save:
Follow These Markers to Ferret Out Chronic Migraine Diagnosis
Remember, ‘chronic’ is in the eye of the payer. Many medical practices, es... Read more
You Be the Expert:
Look for Additional E/M on Unscheduled Procedure Encounters
Question: I am doing some light coding under the supervision of a senior coder. I w... Read more
Reader Question:
Start Your ICD-10 Training with Root Work
Question: In addition to my duties as practice manager at our mid-sized medical pra... Read more
Reader Question:
Keep Out of the Headlines by Protecting PHI
Question: In past issues of Practice Management Alert, I’ve read several arti... Read more
Reader Question:
Sidestep 'Unprocessable' Denials With These Tips
Question: Due to staff reduction, I have been recruited into doing some coding. I&r... Read more
Compliance:
Get Patient Involved In Benefits Fixes
  Incorrect insurance info? Check with patient first, say experts. In previous ... Read more
Coding:
Use This Critical Care Q&A to Avoid Filing Lifeless Claims
Without a critical illness or injury, you can forget about 99291/99292. One of the mos... Read more
Clip N Save:
Use This List of Interventions to Spot Possible Critical Care
Reminder: Some of the interventions are separately reportable from 99291/99292. There ... Read more
Expert Quick Take:
Mind This Advice if Eligibility Denials Are All Too Common
Expert: There’s no single explanation for why the payer deems a patient ineligible... Read more
You Be the Expert:
Who Is a Business Associate ... and Who Isn't
Question: I have read about business associate agreements (BAAs) in past issues of ... Read more
Reader Question:
Know Pain's Duration, Get Closer to Acute/Chronic Answer
Question: For diagnosis coding purposes, what is the difference between acute and c... Read more
Reader Question:
Consider AH/AJ Modifiers for Psychiatry Services
Question: Full disclosure: I am new to psychiatry, and I just accepted a practice m... Read more
Reader Question:
ID CPT® 'Family' to Make Correct Modifier Decision
Question: I work at a gastroenterologist’s office, and I’m having some ... Read more
Reader Question:
Wait for Path Report Before Choosing Excision Code
Question: The physician removed a 0.9 cm benign lesion from a patient’s left ... Read more
Compliance:
Validate New Patient Insurance ASAP, Avoid Payment Confusion
Experts: Make sure patient’s insurance info is valid before first visit. Medical... Read more
CPT® Coding:
Learn HPI Levels with This 'Elemental' Knowledge
Make sure payer recognizes duration before counting it on HPI. Anyone who has to file... Read more
Quick Tip:
Observe Certain Subpoenas for Patient Info
Remember: No judge’s decree, no patient info for requester. In past issues of Pr... Read more
ICD-10:
Be Careful When Choosing Dx for Discharges
Remember, diagnoses can change during hospitalization. A patient entering the hospital... Read more
You Be the Expert:
Clearing Up Questions on Eye FBR Coding
Question: I was helping out with coding recently, doing the best I could to code an... Read more
Reader Question:
Base Coder Job Description on These Necessary Traits
Question: We are in the process of hiring a new full-time medical coder for our ort... Read more
Reader Question:
Use This List of Phone Tips to Coach Up Staff
Question:We are a small practice, and everyone has to answer the phone from time to time... Read more
Reader Question:
Make Sure Patients Understand EOB's Purpose
Question: We often get patients who call the practice with questions about their ex... Read more
Patient Relations:
Make Record Request Responses a Top Priority
Patient relationships are at stake when someone requests medical record. When a patien... Read more
Compliance:
Put Self-Audits on Front Burner, Stay Ahead of Payer Issues
Experts: Annual self-audits are a good idea. In the previous edition of Practice Manag... Read more
FAQ:
Clear Up Any SNF Coding Snafus Before They Blossom Into Big Trouble
Here’s one RAC that could show you problem areas. Practices whose physicians per... Read more
You Be the Expert:
Get Off on Right Foot with FBR Coding
Question: A 44-year-old established patient reported with a splinter lodged in his ... Read more
Reader Question:
Tailor Job Descriptions to Meet Practice Needs
Question: Our practice is looking for a new medical office receptionist. What are s... Read more
Reader Question:
Count Global Days Before Bringing Modifier 24 to Claim
Question: An established patient reported to the practice on for treatment of a bro... Read more
Reader Question:
Take These 5 Steps Toward Eliminating Office Conflict
Question: We are having a problem with two of our nonphysician practitioners (NPPs)... Read more
Reader Question:
Check Out J Codes for 'Novel' Flu Dx
Question: What is the proper ICD-10 code for swine flu? Oregon Subscriber Answe... Read more
Collections:
Put No-Shows on Notice with Stout Policies
Get patient’s signature on any practice no-show policy. There are no cut-and-dri... Read more
Compliance:
Know Your Vulnerabilities Before Auditors Come Knocking
Focus on these hotspots to reduce audit risk. Even if your practice puts the stronges... Read more
Modifiers:
Weather Disaster-Related Coding with Modifier CR Savvy
Here’s why your practice should stay alert if a catastrophe happens nearby. The ... Read more
You Be the Expert:
Disclosing Px Exam/Test Results
Question: When an employer pays our medical office to perform drug tests, fitness-f... Read more
Reader Question:
Use Split Visit Rules to Duck 15 Percent Pay Cut
Question: I’ve heard nurse practitioners (NPs) and other providers talk about... Read more
Reader Question:
Make Sure All Your Providers' Signatures are Valid
Question: I’m having trouble getting my physicians to sign their claim forms.... Read more
Reader Question:
Report ICD-10 Code R09.89 for a Range of Symptoms
Question: Our cardiology practice is having trouble crosswalking “abnormal ch... Read more
Collections:
Reduce Copay No-pays with Set Policy
Obtain signed financial responsibility form as insurance against nonpayment. Most medi... Read more
Patient Relations:
Avoid Confrontation at All Costs When Collecting Copays
Experts: Give patients a few chances to pay, then call collections. A patient flat-out... Read more
Appeals:
CMS Guidance Focuses Contractors' Review Procedures
Here’s why this news could lead to higher appeals acceptance. The Centers for Me... Read more
Coding:
Check Out How Different Dx Codes Can Help You Make E/M-25 Decision
Prove separate services before reporting separate E/M. When reporting CPT® codes f... Read more
You Be the Expert:
Reporting Multi-Modifier Claims
Question: We have a small practice in a designated health professional shortage area (HP... Read more
Reader Question:
Consider Resources before Deciding on SOP Writers
Question: We are a 10-physician practice that is rapidly expanding; we only had three ph... Read more
Reader Question:
Prevent Winter Blues Before They Affect Bottom Line
Question: When we return after the holiday season, the winter blues start to set in. As ... Read more