AAOS Now, November 2015
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That Was Then, This Is Now: Arthroscopic Subacromial Decompression
This is the first in a series of articles updating previous AAOS Now coding articles. Since the original article was published in August 2013, the Centers for Medicare & Medicaid Services (CMS) has released specific instructions related to shoulder coding. This article addresses the implications of Medicare's coding and payment rule, as well as Medicare's National Correct Coding Initiative (NCCI) edits for Medicare Part B services and the Medicare Outpatient Code Editor (OCE).
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Meeting the Needs of the Contemporary Patient
Given the complexity of payment realities, the burden of quality initiatives, and the uncertain nature of future regulations, it may be a slight overstatement to say, "The future is bright for orthopaedic surgeons." However, orthopaedics has a silver lining. Demand for services will increase over the next decade due to an aging and obese patient population and improvements in technology.
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Pearls and Nuggets for ICD-10
The following bits and pieces of useful information for coders and physicians deserve discussion and definition. "Specificity" in diagnosis coding is the ultimate goal. To achieve the highest specificity, particularly as it pertains to acute injuries, thorough and complete documentation is absolutely necessary. Do not use"Unspecified Codes" or"NOS (Not Otherwise Specified)" simply because they are not"specific."
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What You Should Know About the HIPAA Privacy Rule
Headlines about data breaches draw attention to the Health Insurance Portability and Accountability Act's (HIPAA) Security Rule. However, its companion—the HIPAA Privacy Rule—is just as important. Although the two rules work hand-in-hand, they are based on different concepts. The Security Rule oversees the mechanisms used to protect the privacy of electronic patient health information (ePHI), while the Privacy Rule focuses on the use and disclosure of that information.
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Physicians on Record—Without their Knowledge
Are your patients secretly recording their conversations with you? Today, nearly two thirds of Americans own smartphones that, with one touch, can easily and secretly record any conversation—including discussions between physicians and patients. It is unclear how often physician/patient interactions are being recorded—with or without the consent of the physician.