Listserv Lately 15
by Suzan Hvizdash, CPC, CRN Senior Auditor, Instructor
These last two weeks on the list really inspired some thought provoking conversations. We had quite a few questions, as always, on codes, modifiers, and denial issues. Everyone seemed quick to answer the questions posted. It just enforces the power behind this list serve!!
A few topics worth mentioning included a long string about OP note dictation time frames, the proper way to bill prolonged services, and quite an extensive string on the future of medicine. I was really clued to the list for much of these conversations.
First, a lister asked if there are any written regulations regarding the time frame in which a physician must sign the dictated operative notes. And when these are signed must they also be dated? A few responses indicated that the facilities in which they work developed policies, but no sites of regulations were found during the string. The most common answer was that the facility should require these reports to be signed within 24-48 hours after the surgery.
What about prolonged services? Who’s still paying for this? Medicare? Commercial carriers? Medicaid? How should you bill this to insure payment? The consensus on this was that if doctors of the same group see the patient in one day and the service warrants the prolonged service code, the billing should be submitted with the E/M code, the prolonged code, and the –21 modifier. Some payers don’t recognize the modifier thought, so you’ll want to check with your local payers.
Then there’s the on-going conversation about the future of medicine. It started with a lister talking about her experiences at her PCP’s office. She waited several hours to see the patient, however, had she paid for a membership, she wouldn’t need to have waited. This appears to be an office taking advantage of the new wave of medicine some are calling “concierge services”. This began a very thought provoking debate on everything from whether patients “deserve” service to the current insurance company payment trends. It is amazing when you have so many pieces of a pie participating in a debate.
So until next time, keep those questions and answers flowing, the dialogue is impressive!
Until next time,
Joining the list serve: $0
Asking questions on the list serve: $0
Reading your bi-weekly CRN newsletter: $0
Advice received on the list serve: Priceless
The value of reading your bi-weekly CRN newsletter: Priceless
-- Suzan