Jan 1st, 2008
Modeling ASCs on APC Elements Means New Approaches Needed By A. Scott Freathy, MD, CPC The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 required the Department of Health and Human Services (HHS) to develop and implement a revised ambulatory surgery center (ASC) payment system by Jan. 1, 2008. The final rule was published ...
Jan 1st, 2008
Billing successfully for an assistant at surgery is all  in the way physicians document op reports and coders attach modifiers. By Susan Vogelberger, CPC, CPC-H, CMBS, CCP To bill for an assistant at surgery, the surgeon is required to specify in the body of the operative report what the assistant actually does. It is not ...
Jan 1st, 2008
By Lori J. Strauss, RN, MSA, CHC, CPC, CPC-H The term medical necessity has been a theme of the Office of the Inspector General’s (OIG’s) Work Plan since 2003. On the website www.medicare.gov, the U.S. Department of Health & Human Services defines medically necessary as “Services or supplies that are proper and needed for the ...
Jan 1st, 2008
By Stephen C. Spain, MD, FAAFP, CPC Hardworking Dr. Smith is visibly troubled as she pushes the letter across her desk for you to read. She summoned you, the office coding specialist, shortly after she received the certified letter from ACME insurance company. You carefully digest each word of the letter, which ominously informs the ...
Jan 1st, 2008
Recognizing Non-physician Practitioners for Payment Purposes Requires Attention to Detail. By Robert A. Pelaia, Esq., CPC Non-physician practitioners, such as physician assistants and advanced registered nurse practitioners, are becoming more and more of a presence throughout the healthcare industry. These non-physician practitioners are permitted to bill the Medicare program under their own provid...