Physicians Practice - January 2008 - (Page 46)

ASK THE EXPERTS A I did ﬁnd one resource online: www.npcentral.net/protocol/. Also, it actually would be good for the NP to take charge of this, writing down the systems she and the physician agree to for certain conditions, then making sure the physician signs off on it. This will set in stone what they work through as they get to know each other. CODING A SCREENING COLONOSCOPY Q If a patient is referred to our office for a screening colonoscopy and she is asymptomatic, how should we code this encounter? A Let me make sure I have this right: The patient comes in, is asymptomatic, but needs a screening colonoscopy just because she is at normal risk and you are coding for the colonoscopy. Correct? If so, use ICD-9 V76.51, Special screening for malignant neoplasm, colon, as the ﬁrst diagnosis code. Then CPT 45378, Colonoscopy, ﬂexible, proximal to splenic ﬂexure, diagnostic (assuming a non-Medicare patient). If, however, you are asking about getting paid for a visit before the procedure, Medicare and most other payers typically won’t pay for E&M visits on the day of or the day prior to surgery unless that is the visit that led to the decision for surgery. Some payers extend this to 30 days. What is relevant here is whether the physician needs to see the patient to determine the need for the procedure or if the procedure is why the patient was referred in the ﬁrst place. If your physician is doing the E&M visit to evaluate and diagnose the patient and then decides to do the colonoscopy, he should get paid. For the ICD-9, then, you would code the condition the patient came in for. GROSS VERSUS NET COLLECTIONS Q I am new to my practice, and have noticed that its gross collection percentage is down. I’m trying to figure out why. What do you suggest? A I’d basically ignore gross collection percentage. All it does is say what percent you collected of what you charged. What matters is what you collected of what you are owed. Here is what likely happened: Last year, you charged, say, $100 for a 99212. Insurance paid $80. That equals an 80 percent gross collection rate. This year, you charged $120 and still got paid $80 (or perhaps $84, since you negotiated better rates). That equals a 70 percent gross collection rate. It sounds worse, but, really, you are collecting about the same amount. Conversely, it’s easy to make your gross collection rate look great by dropping charges, but it’s actually meaningless. Instead, ask for reports on adjusted collections. Are you collecting most of what you are contractually supposed to collect? When it comes to collections, history may be less important than in other areas. More is always better, and everyone should push for more no matter what happened in the past. QUESTIONS TO ASK ON TAKING OVER A PRACTICE GET INVOLVED DO YOU WANT YOUR VOICE HEARD? Physicians Practice is forming a Physician’s Panel to offer feedback and suggestions to the editors of our magazine and Web site, www.PhysiciansPractice.com. Here’s your chance to help guide the editorial content of America’s Leading Practice Management Journal. What’s in it for you? • It’s simple. You need only to communicate with our editors from time to time via e-mail, and accept the occasional phone call. We’d like your views on how well we’re serving your needs, and how we can do better. Q I know a physician with a well-established practice. Two years ago, he started another practice. He drives back and forth every day; it takes about 40 minutes. He’d like to sell me the second practice so he can spend more time with his family. He says he has around 500 patients and that the practice pays for itself. He will give all the financial information to my accountant and lawyer. The rent is expensive. On the other hand, there is a hospitalist in that community so I could stop doing rounds. He told me, “Make an offer.” Do you have any ideas of good questions I should ask? A Well, I’d start by asking yourself if you want to live and work in this other community for personal reasons, too. Moving is stressful. Then, I’d suggest hiring a consultant experienced in practice valuation and start-ups to advise you on the pricing. Look closely at the numbers the physician provides; you need to empower yourself here: WWW.PHYSICIANSPRACTICE.COM • It’s private. We will NEVER share your e-mail address or other private information with outsiders without your explicit permission. • It’s your chance to be heard. In a world that too often takes practicing physicians for granted, we strive to be your voice. Here’s your chance to make sure we’re staying on message. Interested? Just send an e-mail to editor@physicianspractice.com or call Executive Editor Bob Keaveney at 443 543 5141, and tell us a little about yourself and your practice. It’s that simple. 46 | PHYSICIANS PRACTICE | JANUARY 2008 http://www.npcentral.net/protocol/ http://www.PhysiciansPractice.com http://www.PhysiciansPractice.com http://WWW.PHYSICIANSPRACTICE.COM

Table of Contents Feed for the Digital Edition of Physicians Practice - January 2008

Physicians Practice - January 2008 Contents The Bigger Picture: Fixing Medicaid Letters Physicians Practice Pearls: You Can Teach an Old Dog New Tricks Noteworthy Cover Story: Fee Schedule Survey: 2007 Results Adding Ancillaries: Bucking the Practice Ask the Experts Idealab: 'How I Got Over My EMR Excuses' Technology: Don't Be Denied The Tech Doctor: Blessing or Curse? The Administrator's Desk: Learning From the Best Coding Career: To Partner, or Not? Management: Controlling Your Inventory Human Resources: How to Fire an Enployee Finance: Beyond Reimbursment - How to Fix Your Mix Classifieds Advertiser Index

Physicians Practice - January 2008

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