HEALTHCARE BUSINESS MONTHLY December 2015 www.aapc.com Coding | Billing | Auditing | Compliance | Practice Management Let Blood Transfusion Payment Flow: 25 Keep revenue roads clear of denial roadblocks Watch Out for Identity Thieves: 42 Protect patients from losing their medical identities Note Medical Scribes: 50 Qualified scribes can streamline processes DME, Dental, Drugs, Supplies, and Quality Retail $99.95 Member $59.95 AAPC - CodeBooks ORDER YOUR BOOK TODAY! 800-626-2633 Advancing the Business of Healthcare www.aapc.com/medical-coding-books Healthcare Business Monthly | December 2015 COVER | Coding/Billing | 29 Sneak a Peek at 2016 CPT® Changes G.J. Verhovshek, MA, CPC, and Raemarie Jimenez, CPC, CPB, CPMA, CPPM, CPC-I, CANPC, CRHC [contents] ■ Coding/Billing ■ Auditing/Compliance ■ Practice Management 40 Make the Most of HCCs 42 Nobody Is Immune 50 The Medical Scribe: Colleen Gianatasio, CPC, CPC-P, CPMA, CPC-I to Medical Identity Theft A Hot Commodity Jonnie Massey, CPC, CPC-P, CPC-I, Renee Dustman CPMA, AHFI [continued on next page] www.aapc.com December 2015 3 Healthcare Business Monthly | December 2015 | contents 12 ■ Code of Ethics ■ Facility 10 Ethics Update Strengthens 25 Blood Transfusions: Document AAPC Membership Properly for ICD-10-PCS AAPC Ethics Committee Diana H. Williams, BS, CPC, CCS-P, CCS, CPMA ■ AAPC Chapter ■ Added Edge Association 36 Distance Learning: 12 Make Your Chapter a Success Choose Wisely Faith C.M. McNicholas, RHIT, CPC, CPCD, Dawn Moreno, PhD, CPC, CBCS, CMAA, PCS, CDC MTC, CPL, CLT ■ 22 ■ Added Edge Auditing/Compliance 14 How a Credential Is Born 44 Handling PHI Glenda Hamilton, CPC, COC, CPMA, CEMC, Disclosure for Genealogists CPC-P Joseph de Beauchamp, PhD ■ Coding/Billing ■ Practice Management 16 Medicare Primary Care 47 Boost Your Immune Center Exception Update System with Office Yoga Maryann C. Palmeter, CPC, CENTC, CPCO Bridget Toomey, CPC, CPB, CRCR, RYT-200 20 Claim All Your Pennies for 54 Onboarding Employees Discontinued Procedures in a Small Office Ellen M. Wood, CPC, CMPE 54 Sarah W. Sebikari, MHA, CPC 22 Specimen Validity Testing ■ Member Feature Frank Mesaros, MPA, MT (ASCP), CPC 56 Military Members: Trained for Success 26 Coding that Brings You to Your Knees Michelle A. Dick Ken Camilleis, CPC, CPC-I, COSC, CMRS, CCS-P COMING UP: • 2015 Salary Survey • 2016 OPPS DEPARTMENTS EDUCATION • OIG Work Plan 7 Letter from CEO 60 Newly Credentialed Members • Pediatric Vaccination 8 Letters to the Editor • 36415 Venipuncture 9 Healthcare Business News Online Test Yourself – Earn 1 CEU 10 Code of Ethics On the Cover: John Verhovshek, MA, CPC, and Raemarie Jimenez, www.aapc.com/resources/publications/ CPC, CPB, CPMA, CPPM, CPC-I, CANPC, CRHC, give you a sneak peek into 66 I Am AAPC healthcare-business-monthly/archive.aspx what changes are in store for CPT® 2016. Cover design by Kamal Sarkar. 4 Healthcare Business Monthly ZHealth Publishing, LLC C M www.zhealthpublishing.com Y CM MY CY CMY K Serving 153,000 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: December 2015 • You will save a few trees. • You won’t have to wait for issues to come in the mail. Director of Publishing 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 ...........................................39 Designer www.HealthcareBusinessOffice.com Mahfooz Alam Optum360TM A leading health services business ................67 Kamal Sarkar www.optumcoding.com Advertising Jon Valderama Supercoder, LLC ................................................................... 8 www.SuperCoder.com Address all inquires, contributions, and change of address notices to: ZHealth Publishing, LLC ...................................................... 5 Healthcare Business Monthly PO Box 704004 www.zhealthpublishing.com Salt Lake City, UT 84170 (800) 626-2633 vendor index vendor ©2015 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. CPT® copyright 2015 American Medical Association. All rights reserved. Fee schedules, relative value units, conversion factors and/or related components are not as- 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- 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 luck would have it, you do! AAPC’s Legal Advisory Board (LAB) is ready, willing, and Volume 2 Number 12 December 1, 2015 able to answer your legal questions. Simply send your health law questions to LAB@ Healthcare Business Monthly (ISSN: 23327499) is published monthly by AAPC, 2233 South Presidents aapc.com and let the legal professionals hash out the answers. Select Q&As will be Drive, Suites F-C, Salt Lake City UT 84120-7240, for its paid members. Periodicals Postage Paid 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 CEO Work Worth Doing s I reflect on the past year, I am remind- Certified Inpatient Coder (CIC™) and Certi- A ed of something Theodore Roosevelt said: fied Risk Coder (CRC™) credentials and cur- “Far and away the best prize that life has to of- riculum. New online education modules help fer is the chance to work hard at work worth members of all disciplines. Look for more doing.” Events outside AAPC and your re- training and credential opportunities in 2016 quests provided many challenges and oppor- to keep current with the business of health- tunities we resolved to address. Our drive to care. serve members prompted several accomplish- Improved, Less Expensive Codebooks – ments this year, and I’m grateful to be part of AAPC responded quickly to member feed- an organization that achieved the following: back surrounding our AAPC codebooks. We 150,000th Member – We welcomed Ele- made a number of adjustments that will make na Kuklina, PhD, as our 150,000th mem- the books easier to use as coding and educa- ber this year. The Centers for Disease Control tion tools. The low priced books continue to and Prevention (CDC) health scientist and help practicing coders and students. Emory University adjunct professor joined HEALTHCON – We had record-breaking AAPC to seek training and certifications that attendance at AAPC national conference this would help her in her obstetrics and gynecol- year. We hope you enjoyed all of the new ogy research. tracks and sessions we added to better meet ICD-10 Implementation –AAPC members your needs. AAPC members and and staff were instrumental in making this AAPC continues to augment its impact as we year’s long-awaited ICD-10 implementation serve members through meaningful certifi- staff were instrumental go smoothly. AAPC members served as ed- cation, education, and service. We have com- ucators, coordinators, and leaders in the in- pleted a great deal but have a lot more hard in making this year’s dustry as the country transitioned from ICD- work worth doing. AAPC will continue to 9 to the new diagnosis code set. AAPC will serve members through meaningful certifica- long-awaited ICD-10 continue to support you with advanced train- tion, education, and service. — and that’s our ing opportunities, based on what you’ve told prize as we find ways to better serve you and implementation go us you want to learn about this new code set the organizations for which you work. and its use. Here’s to a successful 2016! smoothly. Code of Ethics – The National Advisory Board’s Ethics Committee released an updat- ed Code of Ethics to better respond to mem- Sincerely, bers’ changing work environments. Simpli- fied and meaningful, the Code of Ethics holds members to the highest standard. Adherence to these ethical standards instills public con- fidence in the integrity and professionalism of AAPC members. More Customer Service Staff – To help serve Jason J. VandenAkker you better and reduce wait times, we more CEO than doubled AAPC’s Service Center staff since the beginning of the year. We also added Online Chat as another way for you to reach an AAPC customer service professional.