HEALTHCARE BUSINESS MONTHLY July 2016 www.aapc.com Coding | Billing | Auditing | Compliance | Practice Management Get Paid for Smoking Cessation: 22 Don’t give up on reimbursement: Verify coverage Exude Confidence as an Auditor: 52 Ditch the emotional baggage and gain respect Tips to Improve HEDIS Scores: 60 Enhance quality of care and reduce costs Smart Design. Intelligent Auditing. Healthicity - 1 Customize, manage, train and simplify your audit process. We streamlined your audit process by merging audit workflow, management, and reporting capabilities into one easy-to-use, web-based solution. HEALTHICITY.COM/AUDITMANAGER Healthcare Business Monthly | July 2016 COVER | Coding/Billing | 38 Secrets of Successful Coders Apply 14 strategies to help you climb your way to coding success. Smart Design. By Stephanie Cecchini, CPC, CEMC, CHISP Intelligent Auditing. Healthicity - 1 [contents] ■ Coding/Billing ■ Added Edge ■ Practice Management Customize, manage, train and simplify your audit process. We streamlined your audit process by merging audit workflow, management, and reporting 22 Get Paid for Smoking Cessation 52 Ditch the Emotional Baggage to 56 Manage Hospital capabilities into one easy-to-use, web-based solution. Kasandra Bolzenius, CPC Become a Respected Auditor Staff Cellphone Distractions Holly Pettigrew, COC, CPC, CHC Michelle A. Dick HEALTHICITY.COM/AUDITMANAGER [continued on next page] www.aapc.com July 2016 3 Healthcare Business Monthly | July 2016 | contents 16 ■ Member Feature 14 Emory Physician Group Practice Celebrates and Prepares Its Coders Donna Beaulieu, CRC, C-CDIS, CPC-I, CPMA, CPC, CEMC, CEDC, CFPC, CCP-P, CRP Hasan Zaidi, MPH, CPC, CEDC, CSPPM ■ Coding/Billing 16 MACRA FAQs Renee Dustman 20 Think Twice Before Sticking It in Your Ear Maryann C. Palmeter, CPC, CENTC, CPCO, CHC 24 Providers vs. Payers: Collaboration is the Best Medicine 24 Susanne Myler, COC 28 Cut Costs with Quality Transitional Care Management Stephen Canon, MD 32 Combat Common Denials in Orthopedic Coding Michael Strong, MSHCA, MBA, CPC, CEMC 42 Soothe the Sting of 2016 Paravertebral Block Changes Amy C. Pritchett, BSHA, CPC, CPMA, CPC-I, CANPC, CASCC, CEDC, CRC, ICDCT-CM/PCS 44 ICD-10 Restricts Same-day Sick and Well Visits Debra Mitchell, MSPH, COC 48 WHO Winds Its Gears for ICD-11 50 Brad Ericson, MPC, CPC, COSC 50 The Latest on Multianalyte Assays with Algorithmic Analyses John Verhovshek, MA, CPC ■ Auditing/Compliance 54 Guard PHI with Sensitivity Andy Rusch, CPC ■ Practice Management 60 HEDIS: Manage Your Healthcare Outcomes Lynn Stuckert, LPN, CPC, CPMA COMING UP: DEPARTMENTS 66 Minute with a Member • Cardiac Cath Reports 7 Letter from Member Leadership • Officer Nominations EDUCATION 8 Letters to the Editor 62 Newly Credentialed Members • Audit Defense 9 I Am AAPC • Medical Device Credits 10 AAPC Chapter Association • ICD-10 Best Practices 11 AAPC National Advisory Board On the Cover: Stephanie Cecchini, CPC, CEMC, CHISP, reveals 14 Online Test Yourself – Earn 1 CEU secret strategies that will help you climb your way to coding success. 12 Chapter News www.aapc.com/resources/publications/ Cover photo by Rachel Momeni. 47 Dear John healthcare-business-monthly/archive.aspx 4 Healthcare Business Monthly Page 5_HBM-July-2016 edits02_ALAM.pdf 1 13/06/16 4:51 pm You’ve studied for the CPC exam, but is it enough? Increase your chances of success with a focused online exam review. C M Y CM MY AAPC Membership - Virtual CY CMY K Course students will: It's no secret that the CPC exam can be ● Learn testing strategies. challenging. This review was designed to focus ● Review frequently missed questions. on both the common and most challenging ● Participate in a focused review of testing sections. coding concepts of the CPC exam. ● Have Access to on-demand recorded classes for six months. The CPC Online Exam Review is an on-demand learning system, where students can study and learn at their own pace. Visit aapc.com/CPCOnlineReview or call on of our academic advisors at 877-524-5027 Serving 156,000 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 2016 • 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 • 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. Go into your Profile on www.aapc.com and make the change! Editorial Michelle A. Dick, BS Renee Dustman, BS HealthcareBusinessOffice, LLC ............................................31 Graphic Design www.HealthcareBusinessOffice.com Mahfooz Alam ionHealthcare .................................................................... 58 www.ionHealthcare.com Advertising Ohana Healthcare, LLC ....................................................... 65 Jon Valderama www.ohanahc.com [email protected] Optum360............................................................................ 8 vendor index vendor Address all inquires, contributions, and change of address notices to: www.optum360coding.com/transition Healthcare Business Monthly Superbill Consulting Services, LLC ..................................... 65 www.superbillconsulting.com PO Box 704004 Salt Lake City, UT 84170 The Coding Institute, LLC ....................................................47 www.codinginstitute.com/books (800) 626-2633 ©2016 Healthcare Business Monthly. All rights reserved. Reproduction in whole or in part, in The HIPAA Institute ........................................................... 65 any form, without written permission from AAPC® is prohibited. Contributions are welcome. www.hipaainstitute.com Healthcare Business Monthly is a publication for members of AAPC. Statements of fact or ZHealth Publishing, LLC ......................................................27 opinion are the responsibility of the authors alone and do not represent an opinion of AAPC, www.zhealthpublishing.com or sponsoring organizations. CPT® copyright 2015 American Medical Association. All rights reserved. Fee schedules, relative value units, conversion factors and/or related components are not as- Ask the Legal Advisory Board signed by the AMA, are not part of CPT®, and the AMA is not recommending their use. The AMA is not recommending their use. The AMA does not directly or indirectly practice medi- From HIPAA’s Privacy Rule and anti-kickback statute, to compliant coding, cine or dispense medical services. The AMA assumes no liability for data contained or not to fraud and abuse, there are a lot of legal ramifications to working in contained herein. healthcare. You almost need a lawyer on call 24/7 just to help you make sense of all the new guidelines. As luck would have it, you do! AAPC’s Legal The responsibility for the content of any “National Correct Coding Policy” included in this Advisory Board (LAB) is ready, willing, and able to answer your legal ques- product is with the Centers for Medicare and Medicaid Services and no endorsement by the tions. Simply send your health law questions to [email protected] and let AMA is intended or should be implied. The AMA disclaims responsibility for any consequenc- the legal professionals hash out the answers. Select Q&As will be published es or liability attributable to or related to any use, nonuse or interpretation of information con- in Healthcare Business Monthly. tained in this product. CPT® is a registered trademark of the American Medical Association. Medical Coding Legal Advisory Committee: ® TM ® TM ® ® Timothy P. Blanchard, JD, MHA, FHFMA CPC , COC , CPC-P , CPCO , CPMA , and CIRCC are registered trademarks of AAPC. Julie E. Chicoine, JD, RN, CPC Volume 3 Number 7 July 1, 2016 Michael D. Miscoe, JD, CPC, CPCO, CPMA, CASCC, CCPC, CUC 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 Two Unique-to-AAPC Resources Have Unsurpassed Value s I glanced at the table of contents for this Amonth’s Healthcare Business Monthly two things immediately came to mind. My first thought is how fortunate we are to have a monthly publication that provides us with so much valuable information. The topics are current, varied, and answer the needs of members for each of our specialties, jobs, and responsibilities. My second thought is how valuable our local chapters are to members. Local Chapters Bring You the Best at May MAYnia Looking at all the topics that were presented across the country for this year’s May MAYnia, I’m impressed at how the local chapters went all out to provide members with some incredible educational dream jobs because of connections made at Nothing compares opportunities. The topics were just as varied chapter meetings. as the ones presented in this magazine. The only