Changes to the HIPAA Privacy, Security, and Enforcement Rules under the Health Information Technology for Economic and Clinical Health (HITECH) Act
by Bonnie Schreck, CCS, CPC, CPC-H, CCS-P, COBGC - July 29, 2010
On July 8th, 2010, the Office for Civil Rights, Department of Health and Human Services issued proposed changes to the Privacy, Security, and Enforcement Rules that were issued under the Health Insurance Portability and Accountability Act (HIPAA) of 1996. The changes became necessary because of implementation of the Health Information Technology for Economic and Clinical Health (HITECH) Act for improvement of the effectiveness of the HIPAA Rules.
The HITECH Act (the ‘Act’), enacted on February 17, 2009, is a part of the American Recovery and Reinvestment Act (ARRA) of 2009, which is intended to promote the widespread adoption and standardization of health information technology, including electronic medical/health records. The following are the proposed changes:
Tip of the Week: Angioplasty of Peripheral Arteries and Veins
by Bonnie Schreck, CCS, CPC, CPC-H, CCS-P, COBGC - July 29, 2010
(35450-35460, 35470-35476)
The codes for angioplasty of peripheral vessels are vessel-specific. Separate codes are used for each distinct vessel treated. However, only one code is used for each distinct vessel regardless of how many sites within the vessel are treated or how many balloon inflations are required to relieve the stenosis or obstruction.
Do Not Experiment with Clinical Trial Coding
by Machelle Morningstar, CPC, CPC-H, CEMC, PCS - July 22, 2010
In the past, sponsors of Investigational Device Exemption (IDE) clinical trials have absorbed most, if not all, of the costs associated with the trial by reimbursing physicians and facilities for services provided. More and more in today’s healthcare environment, typical reimbursement for physician services, facility costs, and trial devices, are being paid by Medicare and commercial carriers. While this may not yet be a well-known area of reimbursement, it is here to stay, and with some guidance from Medicare and commercial carriers, it does not have to be an “experiment” in obtaining payment for clinical trial services.
The Food and Drug Administration (FDA), in working with Centers for Medicare and Medicaid Services (CMS), gives clinical trials for medical devices two categories of designation . Category A: Experimental – innovative devices believed to be in class III for which “absolute risk” of the device type has not been established (i.e., initial questions of safety and effectiveness have not been resolved). That is, FDA is unsure whether the device type can be safe and effective. Category B: Non-experimental/Investigational – device types believed to be in classes I or II or device types believed to be in class III where the incremental risk is the primary risk in question (i.e., underlying questions of safety and effectiveness of that device type have been resolved), or it is known that the device type can be safe and effective because, for example, other manufacturers have obtained FDA approval for that device type.
Tip of the Week: Tympanoplasties /Tympanostomies
by Bonnie Schreck, CCS, CPC, CPC-H, CCS-P, COBGC - July 22, 2010
For Medicare, a tympanoplasty or tympanostomy always includes a myringotomy (CPT codes 69420 and 69421) and should not be reported separately. For other payers, check with each to determine coding guidelines.
Welcome to Coder’s Voice
by Bonnie Schreck, CCS, CPC, CPC-H, CCS-P, COBGC - July 22, 2010
Welcome to Coder’s Voice – a new eLetter/blog for and about you and your unique job in healthcare. Written by coders for coders, Coder’s Voice will help you break through the daily noise of healthcare news to focus on the essential elements that concern you. We’ll provide weekly coding tips, news of interest, upcoming events, and a poll so you can see how others in the coding community are thinking about current trends and issues in our industry. Our editorial advisory board will be contributing insightful articles to help you navigate compliance, coding, billing, healthcare reform, ICD-10 implementation and so much more. Plus, we will also throw in some coding humor and brain teasers along the way. Enjoy!
Please let us know what you think. We look forward to hearing from you.
Bonnie G. Schreck, CCS, CPC, CPC-H, CCS-P, COBGC
Director, Clinical Content
Contexo Media
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