HEALTHCARE BUSINESS MONTHLY October 2015 www.aapc.com Coding | Billing | Auditing | Compliance | Practice Management Dig Deep into Debridement: 26 Shed bad coding habits and promote healthy reporting HIPAA Police Are Coming: 50 Identify them and know what they want Cracking the Coding Code: 56 A hospital system improves revenue by supporting its coders HBM-Sep-2016-Advance-Your-Career-Full-Page-1.1-Print-Ready3.pdf 1 9/11/2015 1:14:04 PM Wanting to Advance Your Career? C M Y AAPC - Certification TM CM CIC COC CRC MY CY CMY AAPC’s CIC, COC, and CRC certifications are K the ONLY specialized inpatient, outpatient, and risk adjustment credentials offered in the business of healthcare. Professionals with one of these three specialized credentials can earn up to 61%* more than non-certified professionals. Advance your career today! Visit aapc.com/compare to learn more about AAPC's three newest credentials and how they can elevate your career and increase your earning potential. *Percentages based on 2014 Salary Survey Visit aapc.com/compare and discover which credential is right for you. Healthcare Business Monthly | October 2015 COVER | Coding/Billing | 36 Win the Coders’ Clock Game Billing time-based services won’t be an endurance race if you have a plan of action and follow the rules. Michael Strong, MSHCA, MBA, CPC, CEMC [contents] ■ Coding/Billing ■ Auditing/Compliance ■ Practice Management 22 MDM vs. Medical Necessity: 50 The HIPAA Police Are Coming 54 Customer Service: The Debate Continues Mike Semel The Key to Happy Patients Suzan Berman (Hauptman), MPM, CPC, Tracy Bird, FACMPE, CPC, CPMA, CEMC, CPC-I CEMC, CEDC [continued on next page] www.aapc.com October 2015 3 Healthcare Business Monthly | October 2015 | contents 18 ■ AAPC Chapter 42 Dual Dx Coding for Burns Association Nancy G. Higgins, CPC, CPC-I, CIRCC, 10 ICD-10 Is Here CPMA, CEMC Faith C.M. McNicholas, RHIT, CPC, CPCD, 44 STI Screening Under Medicare CDC, PCS Frank Mesaros, MPA, MT (ASCP), CPC ■ Code of Ethics ■ Auditing/Compliance 11 Ethics Update 48 Regulations that Affect Coding, Strengthens AAPC Documentation, and Payment Integrity and Professionalism Deborah Neville, RHIA, CCS-P Michael D. Miscoe, JD, CPC, CASCC, CUC, CCPC, CPCO, CPMA 48 ■ Practice Management 54 Customer Service: ■ Member Feature The Key to Happy Patients 12 Coding Builds Family Bonds Tracy Bird, FACMPE, CPC, CPMA, CEMC, CPC-I Michelle A. Dick ■ Added Edge ■ Coding/Billing 56 Cracking the Coding 16 Quick Coding for Code at Providence Women’s Preventive Services Marsha McGraw, CRHC Kerin Draak, MS, RN, WHNP-BC, CPC, CEMC, COBGC 60 Wellness Apps That Help You Regain Focus G.J. Verhovshek, MA, CPC 60 Bridget Toomey, CPC, CPB, RYT-200 18 Women’s Preventive Health Update 61 What a Good Online Coding Program Offers Sharon Thompson, MD, MPH, FACOG By Dawn Moreno, PhD, CPC, CBCS, CMAA, 26 Dig Deep into Debridement MTC, CPL, CLT Michelle Hafford, CPC 66 AAPC Raises the Bar with 30 Avoid Common 150K Member: Elena Kuklina Outpatient Coding Errors Michelle A. Dick Marianne Durling, MHA, RHIA, CDIP, CPC, CIC COMING UP: • ’95 vs. ’97 E/M DEPARTMENTS EDUCATION 7 Letter from CEO 62 Newly Credentialed Members • Annual Wellness Visits 8 Healthcare Business News • Lab Follow Ups 9 I Am AAPC • Multi-credentialed Staff • Coding Knee Procedures 11 Code of Ethics Online On the Cover: Michael Strong, MSHCA, MBA, CPC, CEMC, 33 A&P Tip Test Yourself – Earn 1 CEU explains how to bill time-based services without it becoming a coder’s www.aapc.com/resources/publications/ 47 ICD-10 Quiz endurance race. Cover design by Kamal Sarkar. healthcare-business-monthly/archive.aspx 4 Healthcare Business Monthly ZHealth Publishing, LLC C M www.zhealthpublishing.com Y CM MY CY CMY K Serving 150,000 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: October 2015 • You will save a few trees. • You won’t have to wait for issues to come in the mail. Director of Publishing • You can read Healthcare Business Monthly on your computer, tablet, or Brad Ericson, MPC, CPC, COSC other mobile device—anywhere, anytime. [email protected] • 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 American Medical Association ........................................... 25 Renee Dustman, BS www.ama-assn.org and www.amastore.com Designers Billing-Coding, Inc. ............................................................47 Mahfooz Alam www.billing-coding.com Kamal Sarkar HealthcareBusinessOffice, LLC ...........................................33 Address all inquires, contributions, and change of address notices to: www.HealthcareBusinessOffice.com Optum360TM A leading health services business ................67 Healthcare Business Monthly www.optumcoding.com PO Box 704004 Salt Lake City, UT 84170 ProAssurance ......................................................................59 www.Proassurance.com (800) 626-2633 vendor index vendor ©2015 Healthcare Business Monthly. All rights reserved. Reproduction in whole or in part, in Supercoder, LLC ..................................................................15 any form, without written permission from AAPC® is prohibited. Contributions are welcome. www.SuperCoder.com Healthcare Business Monthly is a publication for members of AAPC. Statements of fact or The Coding Institute, LLC ................................................... 29 opinion are the responsibility of the authors alone and do not represent an opinion of AAPC, www.codingconferences.com or sponsoring organizations. The Coding Network .......................................................... 58 CPT® copyright 2015 American Medical Association. All rights reserved. www.codingnetwork.com Fee schedules, relative value units, conversion factors and/or related components are not as- ZHealth Publishing, LLC ...................................................... 5 signed by the AMA, are not part of CPT®, and the AMA is not recommending their use. The www.zhealthpublishing.com AMA is not recommending their use. The AMA does not directly or indirectly practice medi- cine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. The responsibility for the content of any “National Correct Coding Policy” included in this product is with the Centers for Medicare and Medicaid Services and no endorsement by the AMA is intended or should be implied. The AMA disclaims responsibility for any consequenc- es or liability attributable to or related to any use, nonuse or interpretation of information con- Ask the Legal Advisory Board tained in this product. CPT® is a registered trademark of the American Medical Association. From HIPAA’s Privacy Rule and anti-kickback statute, to compliant coding, to fraud and abuse, there are a lot of legal ramifications to working in healthcare. You almost CPC®, COCTM, CPC-P®, CPCOTM, CPMA®, and CIRCC® are registered trademarks of AAPC. need a lawyer on call 24/7 just to help you make sense of all the new guidelines. As Volume 2 Number 10 October 1, 2015 luck would have it, you do! AAPC’s Legal Advisory Board (LAB) is ready, willing, and Healthcare Business Monthly (ISSN: 23327499) is published monthly by AAPC, 2233 South Presidents able to answer your legal questions. Simply send your health law questions to LAB@ Drive, Suites F-C, Salt Lake City UT 84120-7240, for its paid members. Periodicals Postage Paid aapc.com and let the legal professionals hash out the answers. Select Q&As will be at Salt Lake City UT and at additional mailing office. POSTMASTER: Send address changes to: published in Healthcare Business Monthly. 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 the CEO Embrace Seasonal Change n medical reimbursement, October means focused on training, certification, resources, changes. This year’s changes are signifi- and a professional community for our Icant with the implementation of ICD-10 members. You may already have experienced after years of planning, training, and test- Healthicity’s solutions if you have tried ing. I’ve met many of you, most recently at Audicy (www.healthicity.com/audicy), 7Atlis (www. our regional conferences in Dallas and Chi- healthicity.com/7atlis), or other products created cago, and I’m impressed by how much atten- to enhance accuracy and compliance. tion and effort has been focused on success- Additional new and exciting Healthicity ful ICD-10 implementation. It’s satisfying products and services are being developed to hear AAPC members say, “We’re ready,” for commercial release in the near future. when ICD-10 comes up in conversation. Providers are looking to AAPC members to Looking Ahead shepherd them through the transition, and Our membership continues to grow, and I’m they tell me our preparation and confidence excited to welcome Elena V. Kuklina, MD, has calmed their fears about this new code PhD, as our 150,000th member! She is repre- set. We’ll continue to be consulted about the sentative of the future of AAPC. Like AAPC, changes, reimbursement, and problem solving she proactively seeks to uphold a higher stan- surrounding ICD-10