AAOS Now, September 2010
Back to basics
The multiple procedure reduction rule and modifier 51 Occasionally, it’s important to get back to basics. This article takes a back-to-basics look at modifier 51 and the multiple procedure payment policy. When two or more medical procedures are performed during the same session by the same provider, Medicare does not reimburse all procedures at the full billed or allowable amount.
EMR Primer: The next generation
Free primer helps you adopt the latest technology According to the National Center for Health Statistics, just 6 percent of U.S. office-based physicians were using a fully functioning electronic medical records (EMR) system in 2009. Even if the adoption rate among orthopaedists is three times greater than the physician population as a whole, approximately 80 percent of AAOS members are not using a fully functioning EMR system. New technology purchases are always difficult.
Managing implant distribution and costs
Two solutions that put surgeons and hospitals in the driver’s seat For several years, there’s been a disconnect between payments to orthopaedic surgeons who perform joint replacements and the cost of the procedure itself. While reimbursement for a hip replacement fell nearly 26 percent from 1997 to 2007, for example, the “average selling price” of a total joint implant increased more than 130 percent.
A simple way to cut office expenses
The AAOS Group Purchasing Program, Powered by eSurg, can help According to the 2008 Orthopaedic Practice Benchmarking Survey conducted by the American Association of Orthopaedic Executives, the average orthopaedic surgeon spends nearly $34,000 for medical supplies. Supply expenses equal nearly 3 percent of an average office’s total collections.
Michigan project’s response when medical procedures go awry Rick Boothman still thinks about a malpractice case he won 30 years ago. Fresh out of law school, he represented a surgeon who had been sued by a former patient. “As the jury was filing out, the lady who sued my client leaned around the podium and I learned this was the first time she’d talked to him in three or four years,” he recalls. “She said, ‘If I’d known everything you said in the courtroom, I never would have sued you.
Edwin K. Fennell, MD June 9, 2010 Columbia, S.C. Herbert A. Haupt, MD April 2010 Saint Louis Harris H. Kanel, MD June 3, 2010 San Mateo, Calif. William J. Medlicott, MD Dec. 21, 2008 Port Townsend, Wash. A. J. Schoepflin, MD 2007 Ada, Okla. Paul S. Shurnas, MD July 4, 2010 Columbia, Mo.
Litigation alternative: COPIC’s 3Rs program
Disclosure and early reimbursement can deter medical liability lawsuits On April 15, 2010, the New England Journal of Medicine published “Malpractice Reform: Opportunities for Leadership by Health Care Institutions and Liability Insurers.” The article referenced “disclosure and reimbursement programs” and “disclosure and early offer programs.” COPIC Insurance Company’s 3Rs Program is perhaps the best known active disclosure and reimbursement program.
Transforming the medical liability system
D&EO programs can lead to a culture of safety and transparency Conventional tort reform, such as caps on noneconomic damages, can help hold down physician premiums for medical liability insurance as evidenced in California and Texas. Liability reform, however, must do more than just reduce physician premiums.
Reducing dictation expenses
Dictation is an obligatory part of medical practice. Comprehensive office notes are an essential part of the medical record that detail treatment history and are vital protection in a medical liability event. The detail in your notes directly affects your ability to bill appropriately for the evaluation and management of each patient and thus affects reimbursement.