AAOS Now, February 2010
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Medicare fraud hits home
Rising levels of identity theft have become a major issue for prosecutors and law enforcement officials, and given the quantity of identifying information requested by health plans, hospitals, and the government, physicians have become prime targets for scammers. Stolen physician identities can be used in elaborate schemes, particularly with billing for durable medical equipment (DME) for patients covered by Medicare. That’s what happened to one AAOS member, Richard J. Haynes, MD.
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C P T coding updates for 2010 – Par t 2
Casting, spinal codes, and new Category III codes The 2010 Current Procedural Terminology (CPT®) Manual includes several new or revised sections pertinent to orthopaedic surgery. Each year brings with it several new orthopaedic-related CPT codes and guideline changes. Both are significant, and physicians, managers, and coding staff should pay attention to the guidelines for each section so that they are able to incorporate these instructions into daily coding practices.
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Medicare participation options for physicians
Physicians have until March 17 to decide On Dec. 19, 2009, President Obama signed into law legislation postponing the scheduled 21.2 percent cut in the Medicare physician payment conversion factor. Without further action by Congress, however, the cut will go into effect on March 1. All other changes promulgated in the 2010 final physician fee schedule rule went into effect Jan. 1.
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E-prescribing: What’s new for 2010
CMS Finalizes Incentive Program The Centers for Medicare & Medicaid Services (CMS) has finalized provisions affecting the 2010 E-prescribing Incentive Program. As in 2009, eligible professionals who adopt a qualified e-prescribing system and successfully report the e-prescribing measure will earn a bonus of 2 percent of the total estimated Medicare Part B Physician Fee Schedule (PFS)-allowed charges for all covered professional services furnished during the 2010 reporting period.
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CBO revises assessment on impact of tort reform
Reform could reduce budget deficit by $54 billion over 10 years It seems that orthopaedic surgeons have found another friend in Congress—or at least in the Congressional Budget Office (CBO). Douglas W. Elmendorf, the director of the CBO, recently wrote to Rep. Bruce Braley (D-Iowa), explaining why the CBO revised its assessment of the effect that the medical liability crisis has on the economy.
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Punitive damages against physicians in the healthcare reform era
In the context of claims against healthcare providers, most states generally allow punitive damages only in cases involving gross misconduct, an egregious violation of the standard of care, or utter indifference to the well-being of the patient. The line between “mere negligence” and “malicious misconduct,” however, is often blurry. What are punitive damages?