July 2017 www.aapc.com Don’t Let Healthcare Politics Rattle You: 13 Take the lead on healthcare reform Figuring Sedation Time Just Got Easier: 26 Get this moderate sedation calculator Are You a HIPAA Expert or a Flunky? 40 Take a quiz to find out www.aapc.com July 2017 1 Advancing the Business of Healthcare Includes 2018 Guidelines in 1st Edition! We Heard You Loud and Clear AAPC 2018 Code Books are New and Improved AAPC Codebooks You asked, we listened. Our 2018 code books are far superior to anything we’ve ever developed. Thanks to you. In addition to being higher quality, we’ve added these features: More Color HCC Codes Identified in ICD-10-CM Highlighted MACRA Codes for Ease of Use Larger Font New Adhesive Tabs to Decrease Code Look-up Time Illustrations Exclusive AAPC Coding Tips and More... Learn More: aapc.com/2018books Healthcare Business Monthly | July 2017 COVER | Coding/Billing | 28 GLOBAL PERIODS: Let’s Make the Lingo Universal Chandra Stephenson, CPC, CDEO, CIC, COC, CPB, CPCO, CPMA, CPPM, CRC, CCS, CPC-I, CANPC, CCC, CEMC, CFPC, CGSC, CIMC, COBGC, COSC, AAPC Fellow [contents] ■ Coding/Billing ■ Auditing/Compliance ■ Practice Management 24 Approach Matters 46 Title IX Applies to 13 HEALTHCON: A Challenge to Lead for Spinal Arthrodesis Hospital Residency Program Brad Ericson, MPC, CPC, Oby Egbunike, Derek Teeter, JD, BA; and COSC, MACRA Proficient CPC, COC, CPC-I, CCS-P Lorinda Holloway JD, BA [continued on next page] www.aapc.com July 2017 3 Healthcare Business Monthly | July 2017 | contents 20 ■ Member Feature 10 Peers and Coding in Las Vegas Looking Brad Ericson, MPC, CPC, COSC, MACRA Proficient ■ Coding/Billing 20 Make Cleft Lip and Palate Repair a Priority in July to get Renee Dustman, BS, MACRA Proficient 26 Moderate Sedation Calculator Comes to the Rescue Jyoti A. Shah, MCom, CPC, COC, CRC, COSC 32 Encoder Versus ICD-10-CM Codebook certified? 32 Kelly Mitchell, MHA, MSHI, CPC, CGCS, CPMA, CCS 34 Coding Regulations and Quotas Got You Down? Stephanie Cecchini, CPC, CEMC, CHISP, AAPC Fellow, MACRA Proficient 36 Stay Current when Reporting Shoulder Procedures Margie Scalley Vaught, CPC, COC, CPC-I, CCS-P, PCE, MCS-P, ACS-EM, ACS-OR Ruby Woodward, BSN, CPC, CPMA, CPB, COSC, CSFAC ■ Auditing/Compliance 40 HIPAA: Are You an Expert or a Flunky? AAPC Distance Learning Marcia L. Brauchler, MPH, FACMPE, CPC, COC, CPC-I, CPHQ 44 Troubleshoot HIPAA Vulnerabilities with Risk Analysis and Assessment 52 Susan A. Miller, JD ■ Added Edge 50 Provide a Remarkable Teaching Experience Elizabeth Martin, RHIT, CPC, CPC-I 52 Interview with Confidence Judy A. Wilson, CPC, COC, CPC-P, CPB, CPCO, CPPM, CANPC, CPC-I, CMRS, AAPC Fellow 54 Showcase Your Expertise Through Writing Michelle A. Dick, BS Students that complete our For more information or COMING UP: to enroll visit: DEPARTMENTS EDUCATION • Telemedicine courses are TWICE AS LIKELY • Bipolar Disorder 7 Letter from Membership Leader 58 Newly Credentialed Members aapc.com/exam-prep • Virtual Teams 8 I Am AAPC to pass the certification exam. • Job Search Do’s and Don’ts 14 Chat Room HEALTHCON Buzz • Payer Perspective 16 AAPC National Advisory Board CPC COC CIC CRC On the Cover: When you know the lingo of global periods, explains 19 AAPC Chapter Association Chandra Stephenson, CPC, CDEO, CIC, COC, CPB, CPCO, CPMA, CPPM, 56 Member Recognition Online Test Yourself – Earn 1 CEU CPB CPMA CPPM CPCO CRC, CCS, CPC-I, CANPC, CCC, CEMC, CFPC, CGSC,CIMC, COBGC, COSC, www.aapc.com/resources/publications/ AAPC Fellow, correct reimbursement comes naturally. 66 Minute with a Member healthcare-business-monthly/archive.aspx Cover illustration and design is by Mahfooz Alam. 4 Healthcare Business Monthly Looking to get certified? AAPC Distance Learning Students that complete our For more information or courses are TWICE AS LIKELY to enroll visit: aapc.com/exam-prep to pass the certification exam. CPC COC CIC CRC CPB CPMA CPPM CPCO 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: July 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 John Verhovshek, MA, CPC • Digital issues take up a lot less room in your home or office than paper [email protected] issues. Editorial Go into your Profile on www.aapc.com and make the change! Michelle A. Dick, BS [email protected] HealthcareBusinessOffice, LLC ..................................... 31, 53 Renee Dustman, BS, MACRA Proficient [email protected] www.HealthcareBusinessOffice.com The Coding Institute ...........................................................49 Graphic Design Mahfooz Alam www.SupercoderCoder.com/ssa ZHealth ............................................................................. 39 Advertising Sales www.zhealthpublishing.com Corey Stilson [email protected] (801) 236-2225 Address all inquires, contributions, and change of address notices to: AdvertiserIndex Healthcare Business Monthly PO Box 704004 Salt Lake City, UT 84170 (800) 626-2633 ©2017 Healthcare Business Monthly. All rights reserved. Reproduction in whole or in part, in 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. Ask the Legal Advisory Board CPT® copyright 2016 American Medical Association. All rights reserved. Fee schedules, relative value units, conversion factors and/or related components are not From the HIPAA Privacy Rule and anti-kickback statute, to compliant coding, assigned by the AMA, are not part of CPT®, and the AMA is not recommending their use. The to fraud and abuse, there are a lot of legal ramifications to working in AMA does not directly or indirectly practice medicine or dispense medical services. The AMA healthcare. You almost need a lawyer on call 24/7 just to help you make assumes no liability for data contained or not contained herein. sense it all. As luck would have it, you do! AAPC’s Legal Advisory Board (LAB) The responsibility for the content of any “National Correct Coding Policy” included in this is ready, willing, and able to answer your legal questions. Simply send your product is with the Centers for Medicare and Medicaid Services and no endorsement health law questions to [email protected] and let the legal professionals by the AMA is intended or should be implied. The AMA disclaims responsibility for any hash out the answers. Select Q&As will be published in Healthcare Business consequences or liability attributable to or related to any use, nonuse or interpretation of Monthly. information contained in this product. ® Medical Coding Legal Advisory Committee: CPT is a registered trademark of the American Medical Association. 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 7 July 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 Membership Leader MEET AND EXCEED YOUR CAREER EXPECTATIONS Free Online Resources and Tools Whether you have yet to When not at conference, be sure to access wo years ago, when I began my role as AAPC’s website, which houses essential take the challenge, or it’s Tpresident of AAPC’s National Advisory reference materials and tools designed to Board (NAB), I put out a challenge to all help you navigate through your work day. time to reassess, AAPC can members: Look at where you are in your The NAB worked with AAPC to create career, and decide where you would like to a host of tools they could offer members help you meet, or even be. AAPC heard my challenge, and upped at no additional cost. Look for these free exceed, your goals. the ante in its efforts to provide valuable or low-cost materials and tools under the resources to members. Whether you have yet “Resources” tab in the Coding/Billing to take the challenge, or it’s time to reassess, Solutions section at www.aapc.com: AAPC can help you to meet, or even exceed, • Code Lookup with AAPC Coder Get on Track for a Successful Career your goals. Consider these resources as you • Coding Data Files Whether it’s online or in person at an event, set along the path to success. • ICD-9 to ICD-10 Code Converter AAPC strives to get you on track and keep you there. But you must choose your own • Other ICD-10 Codes / Resources Conference track. What are you waiting for? Take the • CPT® codes Local, regional, and national conferences of- challenge, today! As you move forward fer fantastic educational experiences, which • HCPCS Level II codes toward your goals, remember that your NAB are sure to boost your career. • E/M Analyzer representatives are here for you. We’ve got We had such an incredible turnout at • CPT® RVU Calculator your back! HEALTHCON in Las Vegas this year.