Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCO – Page 8

MD Anderson Pays $4.3 Million HIPAA Fine

August 5, 2018August 28, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

In a time when many scoff at the potential of being levied steep penalties for violation of HIPAA rules, a judge just upheld a fine that the Department of Health and Human Services (HHS) issued in 2017 for Texas-based MD Anderson’s use of unencrypted … For more, read here: AAPC Blog

E/M: 2019 Proposed Physician Fee Schedule – Next Steps

July 17, 2018August 28, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

Proposed changes in the Medicare Physician Fee Schedule (MPFS) for 2019 will change proposed reimbursement single evaluation and management (E/M) rates. Here’s a way for medical coders to see how much the new routes may affect your workplace’s … For more, read here: AAPC Blog

CMS Proposes a Single E/M Payment, Streamlined Doc Requirements

July 13, 2018August 28, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

The Federal Register scheduled for publication on July 27, 2018 will include a proposal for a single E/M payment for new outpatient services, and a different single E/M payment for established outpatient E/M services, regardless of the E/M level subm… For more, read here: AAPC Blog

When Non-Covered and Covered Procedures Are Performed

July 10, 2018August 28, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

There are times when a physician will be performing both covered and non-covered procedures at the same operative session. For example, the surgeon may be performing a septoplasty for a deviated septum (J34.2) and nasal obstruction (J34.89), which is … For more, read here: AAPC Blog

New Jersey’s New Law Aimed Eliminates “Surprise” Medical Bills

July 9, 2018August 28, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

The New Jersey (NJ) governor signed a new law designed to curb the impact of costly “surprise” medical bills when a patient sees a non-participating provider during an admission. The bill is quite complex but tries to balance the needs of patients, … For more, read here: AAPC Blog

Anthem Investigator Charged with Fraud

July 9, 2018August 28, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

A former fraud investigator for Anthem, Inc. is one of five people indicted on federal healthcare fraud charges. Those indicted participated in a multi-year scheme to commit fraud against at least eight health insurance companies. The fraud investigat… For more, read here: AAPC Blog

How to Document E/M with Counseling and Coordinating Care

July 2, 2018August 28, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

The only case when time may be used as the overriding factor in determining an evaluation and management (E/M) level is when counseling and/or coordinating care dominates the encounter, which means that the time expended on counseling and/or coordinat… For more, read here: AAPC Blog

Understand Clearing Houses

June 25, 2018August 28, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

Clearing houses affect revenue flow through denials. Understanding them and their processes helps you speed your re-submissions. After a claim file is sent to the clearinghouse, an edit report is sent back to the practice, indicating claims and charg… For more, read here: AAPC Blog

Modifiers 52 and 53 vs. 73 and 74

June 13, 2018August 28, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

Modifier 52, Reduced Services and Modifier 53, Discontinued Procedure apply to physician services while Modifiers 73 and 74, Discontinued Out-Patient Hospital/Ambulatory Surgery Center (ASC) Procedure Prior to the Administration of Anesthesia and Disc… For more, read here: AAPC Blog

E/M Documentation by Med Students Rules Clarified

June 7, 2018August 28, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

The Centers for Medicare & Medicaid Services (CMS) issued a MLN Matters article ( MM10412 Revised) on May 31 with a retroactive effective date of January 1, 2018 clarifying documentation requirements when performed by Medical Students in a teac… For more, read here: AAPC Blog