Conquer Melanoma Fear: 22 Plan to Implement Better Technology
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May 2017 www.aapc.com Conquer Melanoma Fear: 22 Melanoma awareness sheds light on prevention Plan to Implement Better Technology: 52 Make a smooth transition to a new billing system Prime Yourself for Proper PHI Use: 56 Overcome PHI risks by understanding the basics www.aapc.com May 2017 1 Free certification exam included with training packages through May 31st AAPC Distance learning 877-290-0440 aapc.com/exam-prep Healthcare Business Monthly | May 2017 COVER | Member Feature | 18 Meet 2016 Member of the Year Patti Frank, CPC Michelle A. Dick, BS [contents] ■ Coding/Billing ■ Practice Management ■ Auditing/Compliance 38 Stay Current with 52 Successfully Implement 56 PHI Primer Spine Procedural Coding a New Billing System John Verhovshek, MA, CPC Kim Pollock, RN, MBA, CPC, CMDP Sarah Shaw, CPC, and Nancy Higgins, CPC, CPC-I, CIRCC, CPMA, CEMC [continued on next page] www.aapc.com May 2017 3 Healthcare Business Monthly | May 2017 | contents 22 ■ Coding/Billing 22 Melanoma Knowledge Conquers Fear Brad Ericson, MPC, CPC, COSC 26 Don’t Marginalize Mohs Susan Ward, CPC, COC, CPC-I, CEMC, CPCD, CPRC, and John Verhovshek, MA, CPC 28 Wear Your Detective Hat for Postpancreatectomy Diabetes Mellitus Chandra Stephenson, CPC, CIC, COC, CPB, CPCO, CPMA, CPPM, CRC, CDEO, CPC-I, CCS, CANPC, CCC, CEMC, CFPC, CGSC, CIMC, COBGC, COSC, AAPC Fellow 32 Will We Ever See New E/M Guidelines? 32 Ellen Hinkle, CPC, CRC, CPMA, CPC-I, CEMC, CFPC, CIMC 44 Fracture Diagnosis Coding: Initial Visit vs. Subsequent Visit Diane Barton, CPC, CCS-P, CPMA, CRC, CDEO, AAPC Fellow Intelligent Auditing. 46 Take Time to Understand Time-based Codes Maryann C. Palmeter, CPC, CPCO, CENTC, CHC Now with Analytics. 50 ICD-10 Guideline 19: A Conundrum for Coders Barbara Aubry, RN, CPC, CPMA, CHCQM, FABQAURP AAPC Healthicity 1 54 New Guidance Is Good News for E/M Service Coding 46 Julie Pisacane, CPMA, CPPM, CEMC, CCA Search Our Archives Looking for an old article? Go to the Knowledge Center at www.aapc.com and search using codes, terms, and other hints to access Healthcare Business Monthly articles back to 2008. You’ll also find a lot more about each topic searching the Knowledge Center. COMING UP: DEPARTMENTS EDUCATION • Prolonged Services 7 Letter from Member Leadership 59 Newly Credentialed Members • Diagnostic Test Orders 8 Letters to the Editor • Chapter of the Year 9 I Am AAPC ake the guesswork out o deciding which proiders to audit. ith the power o • Special Investigation Units 10 AAPC National Advisory Board Analytics inside of Audit Manager, you’ll save your audit staff time and effort by • Ophthalmology Updates 12 AAPC Chapter Association 14 2017-2018 AAPCCA pinpointing proiders who are a risk to our organiation. On the Cover: Patti Frank’s, CPC, passion for coding education Online Test Yourself – Earn 1 CEU has earned her AAPC’s 2016 Member of the Year award, as well as giraffe 58 Recognition List status. Cover photo by Aaron Bales of New Vision Photography www.aapc.com/resources/publications/ healthcare-business-monthly/archive.aspx (http://newvisionphotography-kc.com). 66 AAPCCA May MAYnia HEALTHICITY.COM/AUDITMANAGER 4 Healthcare Business Monthly Intelligent Auditing. Now with Analytics. AAPC Healthicity 1 ake the guesswork out o deciding which proiders to audit. ith the power o Analytics inside of Audit Manager, you’ll save your audit staff time and effort by pinpointing proiders who are a risk to our organiation. HEALTHICITY.COM/AUDITMANAGER Serving 165,000 Members – Including You! Go Green! HEALTHCARE Why should you sign up to receive Healthcare Business Monthly in digital format? BUSINESS MONTHLY Coding | Billing | Auditing | Compliance | Practice Management Here are some great reasons: May 2017 • You will save a few trees. • You won’t have to wait for issues to come in the mail. Publisher Brad Ericson, MPC, CPC, COSC, MACRA Proficient • You can read Healthcare Business Monthly on your computer, tablet, or [email protected] other mobile device—anywhere, anytime. • You will always know where your issues are. Managing Editor • Digital issues take up a lot less room in your home or office than paper John Verhovshek, MA, CPC issues. [email protected] Go into your Profile on www.aapc.com and make the change! Editorial Michelle A. Dick, BS HealthcareBusinessOffice, LLC ............................................35 [email protected] www.HealthcareBusinessOffice.com Renee Dustman, BS [email protected] HIPAA Institute .................................................................... 8 www.hipaainstitute.com Graphic Design ionHealthcare .................................................................... 63 Mahfooz Alam www.ionHealthcare.com Address all inquires, contributions, and change of address notices to: medkoder .......................................................................... 63 Healthcare Business Monthly www.medkoder.com PO Box 704004 AdvertiserIndex ProAssurance ......................................................................49 Salt Lake City, UT 84170 www.ProAssurance.com (800) 626-2633 ZHealth ..............................................................................43 ©2017 Healthcare Business Monthly. All rights reserved. Reproduction in whole or in part, in www.zhealthpublishing.com any form, without written permission from AAPC® is prohibited. Contributions are welcome. Healthcare Business Monthly is a publication for members of AAPC. Statements of fact or opinion are the responsibility of the authors alone and do not represent an opinion of AAPC, or sponsoring organizations. CPT® copyright 2016 American Medical Association. All rights reserved. Ask the Legal Advisory Board Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT®, and the AMA is not recommending their use. The From the HIPAA Privacy Rule and anti-kickback statute, to compliant coding, AMA does not directly or indirectly practice medicine or dispense medical services. The AMA to fraud and abuse, there are a lot of legal ramifications to working in assumes no liability for data contained or not contained herein. healthcare. You almost need a lawyer on call 24/7 just to help you make The responsibility for the content of any “National Correct Coding Policy” included in this sense of all the new guidelines. As luck would have it, you do! AAPC’s product is with the Centers for Medicare and Medicaid Services and no endorsement Legal Advisory Board (LAB) is ready, willing, and able to answer your legal by the AMA is intended or should be implied. The AMA disclaims responsibility for any questions. Simply send your health law questions to [email protected] and let the legal professionals hash out the answers. Select Q&As will be published consequences or liability attributable to or related to any use, nonuse or interpretation of in Healthcare Business Monthly. information contained in this product. CPT® is a registered trademark of the American Medical Association. Medical Coding Legal Advisory Committee: Timothy P. Blanchard, JD, MHA, FHFMA CPC®, COCTM, CPC-P®, CPCOTM, CPMA®, and CIRCC® are registered trademarks of AAPC. Julie E. Chicoine, JD, RN, CPC Michael D. Miscoe, JD, CPC, CPCO, CPMA, CASCC, CCPC, CUC Volume 4 Number 5 May 1, 2017 Healthcare Business Monthly (ISSN: 23327499) is published monthly by AAPC, 2233 South Presidents Christopher A. Parrella, JD, CPC, CHC Drive, Suites F-C, Salt Lake City UT 84120-7240, for its paid members. Periodicals Postage Paid Robert A. Pelaia, Esq., CPC at Salt Lake City UT and at additional mailing office. POSTMASTER: Send address changes to: Stacy Harper, JD, MHSA, CPC Healthcare Business Monthly c/o AAPC, 2233 South Presidents Drive, Suites F-C, Salt Lake City UT 84120-7240. 6 Healthcare Business Monthly Letter from Member Leadership Feel the Excitement of May, All Year-round ay MAYnia is here and the excitement complishments are highlighted on pages Mcan be felt from coast to coast. It’s time 18-20 in this issue of Healthcare Business for local chapters to open their doors to Monthly. Member benefits … new members and former attendees, and to create new friendships and renew old ones Realize AAPC Benefits Year-round would make a great topic through networking and learning. This Member benefits are available year-round, to discuss with your peers, is a great opportunity to inform current not just on certain occasions or in May. In members, new members, and potential last month’s Healthcare Business Monthly, either at work or at a members about all AAPC has to offer. AAPC President Bevan Erickson outlined Speaking of great opportunities, we benefits, discounts, and tools available to chapter meeting. also have HEALTHCON and the 2016 all members all the time (Letter from the Member of the Year announcement to look President, page 7). This would make a great forward to this month, not to mention topic to discuss with your peers, either at member benefits to enjoy year-round! work or at a chapter meeting. You can learn more about member benefits on AAPC’s HEALTHCON: What Happens website. in Vegas Shouldn’t Stay There The National Advisory Board (NAB) works Each year, AAPC works hard to provide closely with AAPC to ensure members members with conferences that inspire receive the benefits they need to succeed. If greatness. This year’s HEALTHCON on you have a great idea for a member benefit, May 7-10 in Las Vegas will be no differ- please let us know. Contact information ent: Get ready to learn from an impressive for your regional NAB representatives is lineup of expert speakers, network your located on the AAPC website under My heart out, and have a ton of fun. This is one AAPC > My Local Chapter > Officers and event you shouldn’t keep quiet about! If you Representatives. attend this conference, please share your knowledge with your coworkers and local Take care, chapter members. Congratulations Patti Frank! Each year AAPC recognizes a member, nominated by their peers, who has demon- Jaci Johnson Kipreos, CPC, COC, CPMA, strated excellence in supporting the goals CPC-I, CEMC and mission of AAPC.