ICD-10 Focus on Common Knee and Shoulder Codes

Margaret M. Maley, BSN, MS

Much has been written about the explosion of diagnosis codes under the International Classification of Diseases, 10th Edition Clinical Modifications (ICD-10). The amplified granularity of the system and the addition of laterality coding will certainly have an impact on orthopaedics. The ICD-10 implementation delay until Oct. 1, 2015, gives orthopaedic practices an opportunity to take a focused look at the most commonly used codes in ICD-9 and map them to the corresponding codes in ICD-10.

Data-Supported Outcomes and Quality Improvement

Frederick N. Meyer, MD

With implementation of the Affordable Care Act, change has become the byword for the U.S. healthcare system. The way physicians deliver and get paid for healthcare services is changing, and many physicians have shifted from private practice to hospital employment. These changes—as well as the expectation of additional changes—concern many practicing orthopaedic surgeons. They also create the need for us to lead and manage our practices in new ways.

Getting a Handle on Denials and Underpayments

A.J. Johnson

Five steps to improving your billing performance A.J. Johnson In the average physician office, there can be a wide gap between expected and actual claim reimbursement. In fact, payers make inaccurate payments on one out of every 14 healthcare claims (7.1 percent), according to the 2013 American Medical Association (AMA) National Health Insurer Report Card. This missing revenue isn’t easy to see when it’s hidden.

Groups Must Register for 2014 PQRS

Eligible professionals (EPs) who wish to participate in the 2014 Physician Quality Reporting System (PQRS) program as a group practice can now register for the group practice reporting option (GPRO) at https://portal.cms.gov The registration system is open until Sept. 30 for the 2014 PQRS program. Additional information about the 2014 GPRO registration is available on the CMS website.

The Value of Physician Comanagement Agreements

A roundtable discussion on what comanagement means to orthopaedic surgeons New payment models and an increased emphasis on aligning hospitals and physicians have fostered growing interest in physician comanagement agreements. Under these agreements, which are usually between a hospital and a physician group, the focus is on a specific service line, as well as on improving quality and efficiency. Recently, two members of the AAOS Practice Management Committee—Nicholas V.

Could Your Practice Pass a HIPAA Audit?

Howard Mevis

The Health Insurance Portability and Accountability Act (HIPAA) requires hospitals, physician practices, and other healthcare entities to safeguard the privacy of patient health information (PHI). The Office of Civil Rights (OCR) in the Department of Health and Human Services audits HIPAA compliance and is expected to begin a permanent random HIPAA audit program in late 2014 or 2015.

EHRs and Medical Liability

Thomas B. Fleeter, MD

As electronic health records (EHRs) become a fact of life in a modern medical practice, concerns increase about new risks for medical liability related to their use. Although payers, the federal government, and healthcare systems tout the value of EHRs, many physicians remain skeptical about the value and time savings that supposedly accompany EHRs.