Coding and Documentation Tips for Spinal Injections

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

Mary LeGrand, RN, MA, CCS-P, CPC In recent years, the American Medical Association’s Current Procedure Terminology (CPT) deleted the mainstay facet joint injection codes (64475–64479) and introduced the “all-inclusive” paravertebral facet joint injection codes 64490–64495. These new codes are part of the transition from component coding to the combination codes.

Avoiding Employee Claims of Wage and Hour Violations

Terri Casey, JD

As small business owners, orthopaedic surgeons are well aware of the many state and federal laws governing business practices. Although the Fair Labor Standards Act (FLSA) is often overlooked, small and large businesses can find that violations of this act can result in substantial expenditures of time, energy, and money. Since 2004, the number of FLSA lawsuits tied to wage-and-hour disputes has increased 77 percent, according to the National Employment Lawyers’ Association.

Using Benchmarking for Decision Making

William R. Pupkis, CMPE

In today’s uncertain business climate, managing a medical practice involves much more than simply caring for patients. Although that will always be important, to be successful orthopaedic surgeons and their practice managers must also make informed business decisions. That requires a method to gauge pertinent statistics: benchmarking.

Meaningful Use Incentives: The Money Is on the Table

Thomas C. Barber, MD

Thomas C. Barber, MD A recent report indicated that more than 800 orthopaedic surgeons have successfully implemented a certified electronic medical record (EMR) program and obtained Stage 1 meaningful use incentive payments from the federal government. With more than 22,000 orthopaedic surgeons in the AAOS who could potentially qualify for those payments, that’s disappointing, but not surprising. If you have begun using an EMR, are you working to obtain Stage 1 incentive payments?

Your Most Difficult Patient: The One with Nothing Wrong

Timothy J. Birney, MD; Frederic Platt, MD

Patient A.B. has “never been the same” since her auto accident 9 years ago. While stopped at a red light, her SUV was hit from behind by a slow-moving small car. Although the SUV was equipped with high seat backs, Ms. A.B. was wearing her seat belt, and neither vehicle sustained significant damage, she has suffered from neck and thoracic spine pain ever since the accident. The constant pain, she said, is exacerbated by movement and prolonged sitting. Ms. A.B.

When Patients Refuse Treatment

Is it negligence if the patient elects not to “follow doctor’s orders”? E. Burke Giblin, Esq., and Christina M. Scarpa, Esq. A common theory of negligence raised against physicians, including orthopaedic surgeons, is the doctrine of informed consent. That a doctor has a duty to explain, in terms understandable to the patient, what he or she intends to do before a patient begins a course of treatment is well known.