Ins and outs of Modifier 58

Mary LeGrand, RN, MA, CCS-P, CPC

What does it mean? When is it appropriate? Understanding the definition and applicability of modifier 58 is a key to accurate coding during the global period. Its proper use will also reduce your risk of an audit during the global period.

Seven skill sets for your practice executive

Dale A. Reigle

Management and communication abilities are key In the operating room, orthopaedic surgeons concentrate on surgery, but they must also know enough about the roles of others to ensure they are properly performing their duties. Similarly, in their practices, orthopaedists may not need to be involved in daily management, but they do need to understand what must be accomplished and be able to determine if the practice executive is doing the job efficiently and effectively.

Protect your inventions and intellectual property

Brenna Legaard, JD; Robert N. Lyman, JD

By Brenna Legaard, JD, and Robert N. Lyman, JD A general understanding of patent law is key Surgeons are prolific inventors. They are smart, understand how things work, and are focused on solving problems. In our practice as patent attorneys with many surgeon-clients, we have found that surgeon/inventors frequently test their devices before consulting a patent attorney. They want to know if their inventions work and whether the substantial cost of getting a patent will be worth it.

E-prescribing: An easy way to earn bonus payments

Toya M. Sledd, MPH, MBA

Bonus payments, no penalties make learning easier Beginning this year, AAOS members who e-prescribe can potentially earn a 2 percent bonus payment from the Centers for Medicare & Medicaid Services (CMS), in addition to any Physician Quality Reporting Initiative (PQRI) bonus. The e-prescribing bonus drops to 1 percent in 2011 and 2012, and to 0.5 percent in 2013. After that, the penalties kick in.

Bullies, bad attitudes, and misbehaviors

S. Jay Jayasankar, MD

Acting out is risky behavior for physicians and patients In 2006, a neurosurgeon in Oakland, Calif., allegedly became belligerent—verbally and physically abusive—when told that instruments brought in from another hospital needed to be sterilized before he could operate on a trauma patient. It took three deputies to restrain and arrest him. The patient was subsequently treated safely by another surgeon.

Purchasing alliance pays off in New Jersey

Stuart J. Fischer, MD

Program helps orthopaedic surgeons reduce medical liability insurance costs In September 2008, after 5 months of negotiation and legal preparation, the New Jersey Orthopaedic Society/Orthopaedic Surgeons of New Jersey (NJOS/OSNJ) launched a medical liability insurance risk purchasing group. As a result, New Jersey orthopaedic surgeons who are members of the purchasing alliance received discounts of 7.5 percent (spine surgeons) to 12.5 percent (nonspine surgeons).

The forgotten part of informed consent

Frederic W. Platt, MD

Be sure to discuss what a good outcome looks like Three months after his total knee replacement, Mr. Patient returns to see his orthopaedic surgeon. Dr. Surgeon examines him and finds much to be happy about. Surgeon: “Wonderful! Mr. Patient, this looks great. The knee is no longer red or warm or swollen. You are no longer in constant pain. You’re walking 8 blocks a day, when before you couldn’t walk a block.