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Sean Weiss' Consulting Corner
Welcome to the re-launch of Consultants Corner. This section is being re-launched to enhance our subscribers experience with our magazine. This area has and will continue to be Sean Weiss' section to provide authoritative and expert opinions and advice on dealing with some of the most complex issues facing health care professionals today. Topics will range from practice management, coding/billing and compliance initiatives.
Each week readers can submit their questions and the following week Sean will choose 2 questions and will provide recommended solutions to your issues. Other questions submitted will be used to develop articles for our subscribers, so make sure to submit your questions weekly.
For more information please call (301) 287-2470
Email: Sean Weiss <sweiss@decisionhealth.com>
www.decisionhealth.com/Consulting/consulting.aspx |
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July
2008
What to do When You Are Wrong "The Risks and Benefits of Self Disclosure"
Every practice makes mistakes; after all we are all human. I have been writing for BC Advantage now for almost 4 years and I have had the privilege to get to know a lot of the readers personally. As most of you know, I have been working in healthcare since 1989 in different capacities but have really focused on working with healthcare providers regarding compliance, coding and practice management issues since 1997. During the past eleven years I have run into some very interesting and unique situations and in some cases I found myself just wanting to get out of the facility with all my faculties still in place.
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June
2008
Incident-To: The Rules Just Got Tougher
Incident-To billing provisions just got a bit more difficult to bill for. Pub. 100-02 Medicare Benefit Policy, Transmittal 87, which was released on May 2, 2008 and became effective on June 2, 2008 places further restrictions and requirements on providers if services are to be billed Incident-To. According to the Transmittal the term INCIDENT TO (with or without quotes) refers to services incident to the service of a physician or other professional permitted by statute to bill for services incident to their services when those services meet all of the requirements applicable to the benefit. In addition to the existing guidelines surrounding Incident-To CMS has enacted additional guidelines to make billing for these services a bit more difficult. When we are talking about Incident-To in an office or physician owned and operated clinic, the additional requirements based on the above listed Transmittal are:
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April
2008
Death: How To Code It
Talking about death is never pleasant, however in the health care industry it is a cold reality we cannot avoid. Robert Half once said, "Death is the penalty we all pay for the privilege of life." Dating back to the mid 1990's when I was a Senior Consultant for then Medical Management Institute I always used to get a chuckle form the audience when I was asked how to code for a physician pronouncing a patient's death. My answer with a grin would be "Code it as a discharge, a final discharge." After reading my last sentence it really is much funnier in front of a live audience, not that death is funny.
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April
2008
Modifier 57 with E/M Question
I have been using modifier 57 with E/M when decision for surgery has been made, this could be between 2weeks before the surgery to 1 day before the surgery. A co-worker went to a meeting and they told her to only use modifier 57 when the office visit is within 24 hrs of surgery. Which is correct.
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April
2008
NPP Question
I read all your articles on "Split/Shared Visits and I use it as a guide. I have a question if an NPP helped gather information along with the physician and the physician tells the NPP what to dictate, can the NPP act as a scribe and dictate the consults, critical care and H&P's notes. There is some confusion regarding this issue with the physicians.
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April
2008
Global post-op - Q and A
I work at a provider-based facility. A physician has recently become employed at our facility after working for the other facility in the city. While at the other facility, he performed multiple surgeries on patients that he is now seeing in post-op care at our facility. To bill appropriately from our perspective, do we bill the global post-op code (99024)
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April
2008
Split/Shared Visits - Q and A
I read your article "Split/Shared Visits" and found it to very helpful . We recently added a PA to our surgical office and the rules for PA billing are extremely confusing and many times contradictory by payor. And the recent change by Michigan BCBS regarding PA's has totally muddied the waters with no resolution in sight.
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April
2008
Split/Shared Visits
After spending so much time working with mid-level practitioners around the country in both inpatient and outpatient hospital settings it became obvious to me that there is a lot of misunderstanding regarding how Split/Shared Visits work. A lot of articles focus on "Incident-To" so I thought I would focus on just Split/Shared Visits.
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April
2008
Wishing Someone Special Well
Normally, I write about coding/billing, compliance and practice management issues but I wanted to put that all aside this week and tell you about a very special person that a lot of us in our industry respect, depend on and consider a good friend. The person I am talking about is Mr. Steve Verno. I have had the pleasure of knowing Steve since 2001, when he was an attendee at a conference I was speaking at in New Orleans for The Medical Management Institute. Since that time Steve and I have had several opportunities to spend time together at conferences as well as serving together on the editorial board for BC-Advantage.
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March
2008
Revising The Medicare ABN - What it Means to You
Recently CMS decided to revise their CMS 141G form (better known as the ABN). One of the main changes you will notice is that it is now referred to as the Advance Beneficiary Notice of Noncoverage, which was done to more clearly convey the purpose of the form according to CMS.
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