Part B Insider (Multispecialty) Coding Alert
Physician-Owned Specialty Hospitals Threaten Community Hospitals
PDF
Your physician's cardiac, orthopedic or surgical specialty hospital may be chipping away at your community hospital's profitability, according to a new study.
Also, competition for high-profit cases is leading community hospitals to leave quality and efficiency measures on the back burner, according to a Jan. 25 study from the Center for Studying Health System Change.
Policymakers have been debating whether specialty hospitals hurt community hospitals, and whether they in fact meet the definition of a "hospital." The Centers for Medicare & Medicaid Services last year extended a moratorium on allowing physician-owners of specialty hospitals to refer Medicare patients to their hospitals.
Conflicts of interest: Physicians who own or invest in specialty hospitals may find it difficult to balance clinical decisions with financial ones. Physician-owners' influence on patient flow could lead them to steer the most profitable cases to their specialty hospitals, and away from the community hospitals. Specialty hospitals have a financial interest in avoiding patients who are underinsured or uninsured.
Part B Insider (Multispecialty) Coding Alert
- EVALUATION & MANAGEMENT:
Don't Hold Your Breath For New National E/M Guidelines
But keep an eye open for more carrier-level meddling
The American Medical Association shows no sign [...] - APPEALS:
Claim Denied? Don't Give Up Too Easily
One neurosurgery provider succeeds in convincing payor to cough up
Just because Medicare doesn't cover something, [...] - Last Chance To Weigh In On Your Carrier's Performance
If you received the Medicare Contractor Provider Satisfaction Survey (MCPSS) and didn't respond, it's not [...] - INJECTIONS:
Will CPT 2007 Include A Code For Non-Supervised Injections?
Use 59 modifier for multiple injections per day
When CPT 2006 introduced [...] - Physician-Owned Specialty Hospitals Threaten Community Hospitals
Your physician's cardiac, orthopedic or surgical specialty hospital may be chipping away at your community [...] - NEUROLOGY:
Don't Miss Out On Extra Units With NCS Codes
8 tips to gain your proper reimbursement for 95900-95904
Don't let nerve conduction study (NCS) coding [...] - Bush Budget Calls For P4P--But No More Money
If you were hoping for a nice juicy carrot to encourage you to go along [...] - OPTHOPEDICS:
Alert--Now's The Time To Fight For ESWT Coverage
Two carriers already say they won't cover new code 28890
Coders rejoiced [...] - OTOLARYNGOLOGY:
Reader Question--Clean Up Your Earwax Coding With These Cues
Question: A patient came into our office and noted earwax removal as her chief compliant. [...] - RADIOLOGY:
2 Choices To Chart Your Bovine Arch Coding Course
Uncover the difference between using 2nd- and 3rd-order catheter codes
There isn't one set-in-stone way to [...] - DERMATOLOGY:
Keep Your Eyes Open For Medically Necessary Eyelid Procedures
Carriers will cover blepharplasty for functional or reconstructive surgeries
Medicare is prone [...] - ANESTHESIA:
Learn Why Your Anesthesiologist's Location Matters
3 Important factors help you understand what signifies "physically and immediately available"
An anesthesiologist routinely steps [...] - ORTHOPEDIC:
Say Hello To Specific Prosthesis Complication Codes
996.4 now includes a fifth digit
If you've been using 996.4 (Mechanical complication of internal orthopedic [...] - PODIATRY:
Reader Question--Start Your Diabetic Shoe Program On The Right Foot
Question: Our office is about to start a diabetic shoe program. What must we do [...] - Part B Coding Coach:
6 Shots At Infusion Coding Success in 2006
G codes for chemo are gone--and new CPT chemo administration codes aren't just for chemo [...] - PHYSICIAN NOTES:
ACP Wants To Turn Your Practice Into A Super-Practice
Congress should provide more money to reward physicians for quality
Primary care physicians are falling apart [...]