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Issue #124 - May 6, 2009
AAPC EdgeBlast

PHI Stolen from Va. Govt. Site and Held for Ransom
A hacker replaced a Virginia government Web site last week with a ransom note claiming he’d stolen 8.3 million patients’ personal and prescription drug information and wants $10 million for its return. Read more »

Comment »

Red Flags Rule Postponed to August 1
The Federal Trade Commission (FTC) announced Thursday, April 30, it is postponing implementation of its Red Flags Rule “to give creditors and financial institutions more time to develop and implement written identity theft prevention programs.” The FTC also announced that it is developing templates for smaller businesses that “know their customers,” such as providers. Read more »

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Senate Health Reform Hearings Focus on IT
Continued adoption of health care information technology is critical to health care reform, a spokesman for the Business Roundtable told the Senate Finance Committee today.
Read more »

Comment »

EMRs - The New “Land Rush”
The new federal effort to establish a mandatory electronic medical records (EMR) system in providers’ offices and facilities is being likened to the health information industry’s “Oklahoma land rush.” But critics, health care workers, and health information system industry leaders are expressing caution, a Business Week article says.
Read more »

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DMEPOS Competitive Bidding Program Delayed
At the Obama administration’s request, the interim final rule on the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program went into effect April 18. Read more »

Comment »

Eye Global Surgery E/M Services Under Scrutiny
The Centers for Medicare & Medicaid Services (CMS) reimbursed physicians approximately $1.6 billion for major eye global surgeries performed in 2005. About $97.6 million of those Medicare payments were for evaluation and management (E/M) services included in eye global surgery fees that were more than likely not provided during global surgery periods, according to an Office of Inspector General (OIG) audit. Read more »

Comment »

New Medicare Enrollment Rules Tighten Deadlines
Effective April 1, a policy change mandated in the 2009 Medicare Physician Fee Schedule (MPFS) final rule (FR Doc E8-26213) shortens the time physicians and nonphysician practioners (NPPs) have to retroactively bill for services after successful enrollment into the Medicare program from 27 months to 30 days. The policy change also gives physicians only 30 days to notify Medicare contractors of a change in their practice location. Failure to do so could mean expulsion from Medicare for up to two years, according to an American Medical News story. Read more »

Comment »

PHI Breach Rules Input Sought
The Department of Health and Human Services (HHS) seeks your input on final guidelines regulating the handling of unsecured protected health information (PHI) breaches by May 21. The rules are mandated by the Health Information Technology for Economic and Clinical Health (HITECH) Act. Read more »

Comment »

Portability Issues Give PHRs a Rocky Start
Dave deBronkart, a 59-year-old kidney cancer survivor, was intrigued by the ability to read and edit his medical records but nothing prepared him for what he saw in his own Google Health personal health record (PHR). According to a Boston Globe article, the medical records deBronkart transferred from Beth Israel Deaconess Medical Center to Google Health said his cancer had spread to either his brain or spine and listed several other conditions he had, unbeknownst to him. His blood pressure medication also required “immediate attention,” much to his surprise. Read more »

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Coding Tips
Swine Flu Prompts Coding Concerns
In response to recent human infections of Swine influenza A (H1N1) (swine flu) virus, the Department of Health and Human Services (HHS) issued a nationwide public health emergency declaration on April 26. The Centers for Disease Control and Prevention (CDC) is conducting case investigations, monitoring for illness in swine flu patients’ contacts, and enhancing surveillance to determine the extent of the virus.
Read more »

Comment »

Know Your Cigna: 25 and 59 Require Documentation
Providers submitting claims to Cigna: Make sure to read the private payer’s latest Professional Claims Code Editing and Documentation Requirements Guidelines. Effective April 27, the company now requires supporting documentation for some claims containing modifiers 25 and 59. Read more »

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AUA Updates PSA Screening Guideline for Men
The American Urological Association (AUA) updated, April 27, its prostate cancer screening guideline for men. Well-informed men aged 40 and older who have a life expectancy of at least 10 years should be offered the prostate specific antigen (PSA) test to establish a baseline reading; for men 50 and older, PSA testing should be individualized rather than a blanket annual test, the AUA recommends. Read more »

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Incorrect Units Reporting Adds Up to Costly Mistake
A North Carolina fiscal intermediary incorrectly paid 89 of 91 Medicare claims for oxaliplatin services reviewed in an Office of Inspector General (OIG) audit. Prior to the April 23 report, implicated hospitals had already identified and refunded $1,762,070 in overpayments to Palmetto GBA. The OIG has requested Palmetto GBA recapture the remaining overpayments totaling $160,096. Read more »

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Use V70.7 for Routine Cost of Clinical Trials
Practioners and suppliers no longer need to differentiate between diagnostic and therapeutic clinical trial services on claims processed after July 10, according to the Centers for Medicare & Medicaid Services (CMS). For proper reimbursement, however, they need to follow recently changed Medicare Claims Processing Manual instructions to the letter. Read more »

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Medical News
Mayo Joins Growing Online PHR Movement
The Mayo Clinic recently joined the growing number of providers, facilities, payers, and internet providers keeping and managing personal medical records on the internet. Advocates for Web-based personal health records (PHR) say the technology is more cost-effective and reduces medical errors. Read more »

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Changes Made to HIV Infections Guidelines
The U.S. guidelines for preventing and treating HIV-associated opportunistic infections have been given a complete update for the first time in five years, the National Institutes of Health (NIH) reports. Read more »

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FDA Approves Japanese Encephalitis Vaccine
The U.S. Food and Drug Administration (FDA) approved, March 30, a new vaccine to prevent Japanese encephalitis virus (JEV). IXIARO®, manufactured by Austrian drug maker Intercell AG, is the only vaccine for JEV in the United States. Read more »

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New Treatment Option for Kidney Cancer Patients
The National Comprehensive Cancer Network (NCCN) has updated the NCCN Clinical Practice Guidelines in Oncology™ for Kidney Cancer to reflect March 30 Food and Drug Administration (FDA) approval of everolimas (Afinitor®, Novartis) for advanced renal cell carcinoma. Read more »

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Test Yourself Online
The Test Yourself questions can be accessed online at www.aapc.com/testyourself/. Once you go there and take the test, you can automatically grade your answers, correct any mistakes, and have your CEUs automatically added to your CEU Tracker for submission.

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Featured Items
PHI Held for Ransom
Red Flags Postponed
Senate Hearings on IT
EMR- The New 'Land Rush'
DMEPOS Bidding Delayed
Global Surgery E/M
Medicare Enrollment Rules
PHI Breach Rules Input
PHR Portability Issues
Coding Tips
Medical News
Test Yourself Online
Coding Job Links

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