Place of Service (POS) CMS List Coding Instructions Revised (CR7631).
Every physician or other provider encounter requires a place of service (POS) code for proper claims processing. But how should a physician determine their point of service? The Centers for Medicare and Medicaid Services (CMS) put an end to that question once and for all with Change Request 7631. Apparently, there have been too many errors over too many years with physicians and other providers reporting the wrong site of service location.
As far as I can tell, this Change Request 7631 was originally submitted March 29th, 2012 under Transmittal 2435 in the CMS Manual System. Transmittal 2435...
Source: The Happy Hospitalist - April 17, 2013 Category: Internists and Doctors of Medicine Authors: Tamer Mahrous Source Type: blogs
Avoiding Abuse of Modifier 25
Modifier 25 is frequently used in the wrong context -- sometimes mistakenly but more often as a result of purposeful attempts to increase a practice's level of reimbursements. The modifier is clearly defined as an identifiable evaluation and management (E/M) service performed by the same physician and on the same day as the initial procedure. However, many attempts have been made to stretch this definition in recent years, with some practices trying to use modifier 25 for situations in which the E/M service was performed by someone other than the physician responsible for the procedure in question.
The consequences for mis...
Source: EMR EHR Blog for Physicians - April 1, 2013 Category: Technology Consultants Authors: Aparna Prasad Source Type: blogs
Medical Billing - Think Before You Use Modifier 25 !
Modifier 25 is frequently used in the wrong context -- sometimes mistakenly but more often as a result of purposeful attempts to increase a practice's level of reimbursements. The modifier is clearly defined as an identifiable evaluation and management (E/M) service performed by the same physician and on the same day as the initial procedure. However, many attempts have been made to stretch this definition in recent years, with some practices trying to use modifier 25 for situations in which the E/M service was performed by someone other than the physician responsible for the procedure in question.
The consequences for mis...
Source: EMR EHR Blog for Physicians - April 1, 2013 Category: Technology Consultants Authors: Aparna Prasad Source Type: blogs
Notes from ACC — Day 2
Those of you who run or ride know what the second day back after a break feels like. The first day is awesome. The body is fresh and snappy; there is an adrenaline rush at the start. It’s easy to overcook it on Day 1.
Then there is me at the ACC on day 2. The loss of an hour (damn it, why do we mess with time?) plus the jet lag hit me hard. My mind was foggy most of the day. Anyways, here are a few highlights.
I started the day by going to a very general talk. Dr. Valentin Fuster, perhaps the true grandfather of the ACC, offered a view of Cardiology from the stars. With his beautiful Spanish accent and calm demeanor,...
Source: Dr John M - March 11, 2013 Category: Cardiology Authors: Dr John Source Type: blogs
Iron Deficiency in the Elderly, the Silent Killer
Once more our laxidasical healthcare system has struck my family. My favorite aunt, well into her 80's but living independently with her husband and enjoying life, suddenly goes into congestive heart failure. With encouragement from me, she agrees to go to the emergency, gets the urgent intervention to reverse the failure, and is referred to a cardiologist. Keep in mind she had just been to a cardiologist six weeks before and was told everything was fine----but that is another story. During her stay in the emergency it was found that her blood was down several pints and she was gi...
Source: What's Wrong with Healthcare? - February 25, 2013 Category: Family Physicians Source Type: blogs
From Rock Bottom To The Summit
Dalai's note: My son, Dalai, Jr., wrote this essay for his Freshman writing class. I thought my readers might like it. From Rock Bottom to the Summit The guide, Matt, mumbles something to us about a decent view around the corner as we shoulder our packs. While the rest of us are still gulping water, he takes off down the trail, leaving us stumbling through ankle-twisting sand under the relentless Outback sun. I lean forward as the trail slopes sharply upward and the ground becomes solid rock and the sun slowly disappears. We are in a narrow crevic...
Source: Dalai's PACS Blog - February 10, 2013 Category: Radiologists Source Type: blogs
Interview: Phillip Hornbostle,MD Bariatric Surgeon
This is the first in a series of interviews I plan on publishing. Dr Phillip M. Hornbostel, M.D., FACS, FASMBS is an accomplished bariatric surgeon in Missouri who has performed thousands of weight loss procedures over the years. He is also the resident dean of the commentariat at the physician-only social media website Sermo. The following represents a series of email exchanges he and I had over the holidays:
Dr Hornbostel, tell me about your professional journey from general surgeon to an exclusively bariatric practice.
I finished general surgery residency in 1984 and immediately wen...
Source: Buckeye Surgeon - January 22, 2013 Category: Surgeons Authors: Jeffrey Parks MD Source Type: blogs
Vangina and Fibromyangia as Common Atypical Causes of Chest Pain.
Chest pain is one of the most common and often concerning symptoms for physicians of all training. Tell a dermatologist you've got chest pain and they're calling an ambulance before they remove the maximum number of moles they'll get paid for in one visit. Want to come to the emergency department (ED) to get checked for a pregnancy test? Call an ambulance and tell them you've got chest pain when you take a deep breath in and that your mother just died of a pulmonary embolism. You get a free ride through triage to the front of the line.
The ED will always order a pregnancy test before they order ...
Source: The Happy Hospitalist - January 2, 2013 Category: Internists and Doctors of Medicine Authors: Tamer Mahrous Source Type: blogs
Vangina as a Common Atypical Cause of Chest Pain.
Chest pain is one of the most common and often concerning symptoms for physicians of all training. Tell a dermatologist you've got chest pain and they're calling an ambulance before they remove the maximum number of moles they'll get paid for in one visit. Want to come to the emergency department (ED) to get checked for a pregnancy test? Call an ambulance and tell them you've got chest pain when you take a deep breath in and that your mother just died of a pulmonary embolism. You get a free ride through triage to the front of the line.
The ED will always order a pregnancy test before they order ...
Source: The Happy Hospitalist - January 2, 2013 Category: Internists and Doctors of Medicine Authors: Tamer Mahrous Source Type: blogs
Fourth time's a charm? It better be.
About 2 weeks ago (June 8th) I had my first formal visit with the spine surgeon, along with a medical resident on the surgical team. The conversation was sobering. They admitted that it could be possible to improve my quality of life with another spinal fusion surgery. But, they said, the procedure would be a true challenge for them and the risks would be great for me. There are many factors to consider before surgery even begins, but first… what would they do in the actual surgery?
Step 1: Make an incision on my (most likely) right side, across the ribs and under the arm.
Step 2: Crack a rib or two open (to make roo...
Source: Cancer, life, and me - June 22, 2011 Category: Cancer & Oncology Authors: Chris Tags: General Source Type: blogs
Guest Article: Lessons from the trenches – transitioning to EMR without risking data loss
The government ’s promise of billions in EHR incentives has you interested in what you might be able to get so many of you are looking for advice and lessons learned from practices who have taken the leap to EMRs. I invited James Andrassy_, M.Ed,_ _PA-C__, who_ _has worked as a healthcare provider for the past 3 3 years to talk about some practical lessons. As the practice administrator and network engineer for Gastroenterology Associates of Cleveland and the Cleveland Center for Digestive Health and Endoscopy, he has seen many kinds of problems so_ _I asked him to talk about EMR data management, specifical ly data loss....
Source: The Healthcare IT Guy - August 1, 2010 Category: Information Technology Source Type: blogs
Guest Article: Lessons from the trenches – transitioning to EMR without risking data loss
_The government’s promise of billions in EHR incentives has you interested in what you might be able to get so many of you are looking for advice and lessons learned from practices who have taken the leap to EMRs. I invited James Andrassy, M.Ed,_ _PA-C, who_ has worked as a healthcare provider for the past 33 years to talk about some practical lessons. As the practice administrator and network engineer for Gastroenterology Associates of Cleveland and the Cleveland Center for Digestive Health and Endoscopy, he has seen many kinds of problems so _I asked him to talk about EMR data management, specifically data loss. (S...
Source: The Healthcare IT Guy - August 1, 2010 Category: Information Technology Source Type: blogs
