Blogs

The Medical Record – Best Evidence in Response to Audits (Webinar Replay)

View a replay of the the Medical Record – Best Evidence in Response to Audits webinar. Third party recovery audits have increased significantly over the past several years putting facility and provider revenue at greater risk. During this audit activity, it is the medical record that is being scrutinized – it can either be a facility’s best defense or its worst.

MEGA HIPAA Can Be An Opportunity!

We all know Compliance Officers are more than busy and redoing HIPAA is not always on the front burner.

But given MEGA HIPAA, we all must revisit and enhance our HIPAA programs. This is a perfect time to consider the basics of your program.

Think about it this way: what trends or situations are happening in your organization that might drive basic changes or expansion of your HIPAA program?

It’s not long, but here is my list:

  • Purchase of Physician Practices

Beyond HIPAA: Developing Your Information Security Program

Trust is essential to realizing the benefits that technology is bringing to the healthcare world. With the confidence that healthcare organizations will handle information about them fairly and responsibly, patients are becoming more interested and adept at participating in their healthcare, including having access to their private health information.

Absorbing the Changes for Behavioral Health

2013 marked a significant year for coding changes for psychiatry and psychology. As with other specialties, the AMA provided a clear division of coding for psychotherapy services as opposed to medical management of patient problems.

CMS has adopted most of the new coding regulations put forth by the AMA yet, many state Medicaid plans have narrowed the scope of coverage within the code series.

Maria Bounos from WKLB to co-host ICD10monitor’s Talk Ten Tuesday

News Flash - On Tuesday, March 19, 2013, Maria Bounos, Practice Leader from Wolters Kluwer Law & Business, will be co-hosting ICD10monitor’s Talk Ten Tuesday with the infamous Chuck Buck! The subject for this live weekly podcast is: Why ICD-9 Cannot Support Better Healthcare in America.

2013 Physician Fee Schedule impacted by the American Taxpayer Relief Act of 2012

In response to the passage of the American Taxpayer Relief Act of 2012, CMS has published a revision to the RVU file for January 2013.  The Conversion Factor used to calculate payment was shifted from $25.0008 (reported in the original 01/2013 RVU13A file) to $34.023 (in the replacement RVU13AR file).  The conversion factor used in 2012 was $34.0376.

In addition, CMS has made multiple corrections to other variables, including relative value units for many codes. If you would like to investigate the payment differences, here are several tools to help:

2013 Physician Quality Reporting Initiative Measures

CMS has issued the 2013 PQRI Specifications Manual for Claims and Registry (v 7.2).  This identifies the 202 measures for 2013. 

This resource is available as a browseable e-book in the Coding Suite products Coding & Revenue Resource Center (CRRC) and Audit & Revenue Resource Center (ARRC).  The manual can be found in the CMS - Coding Guidance library under the Quality heading, and will automatically be searched when you click on the Guidance link from the Advanced Code Explorer screen.

Each measure section includes:

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