Physicians Practice - February 2008 - (Page 57)

away). Even the colors and wording of the brochure should carry into the new space and its documents, patient materials, and forms back to referring physicians. Also, devote time and money to a professionally designed piece of marketing collateral. Consider a creative format that echoes your brand promise (e.g., if you promise easy access, make it in the shape of a key or put a Velcro button on the front). Make sure the collateral includes some way for you to know, when physicians call, that they are responding to your marketing piece and not word-of-mouth. Finally, include a plan for follow-up. Once you send the mailer, what is the next step? A postcard? Phone calls to the top 25 targets? Lectures on depression at the local hospital? Use your imagination. STAFF TERMINATION FOR FAKE PRESCRIPTIONS ESTABLISHED VERSUS NEW PATIENTS Q If we consult the patient in the hospital, and he is coming to the ofﬁce for a followup, will this be considered an established patient, a new patient, or a consult? If a new patient is referred from an ER physician, is it a consult or a new patient? A This patient is now an established patient. CPT deﬁnes an established patient as any patient you have seen in the past three years, no matter where the visit took place. I assume the ER doc is transferring care of the patient to you. He has not asked for your opinion while he continues treatment, right? If I am correct, it is a patient visit, not a consult. A consult requires a written request for input and for you to send a written commentary back. EKGs Q A valued employee has been caught falsifying a physician signature on a faxed prescription to an Internet pharmacy for diet pills. Three other members of the staff are using the medications as well. What is the best course of action? Wholesale terminations would be incredibly disruptive, but seems to be a strong possibility. Firing the primary offender alone seems unfair in some ways, although she lied about the transaction when confronted. A I think you must ﬁre all involved employees. You can’t condone this. Do you want your other staff to think it was OK? I think everyone has to go. The only real choice you face is whether to ﬁle charges. Keep in mind that you don’t really know the extent of the problem. Was she selling the pills outside the practice? Was she falsifying other prescriptions? This is fraud. If you simply dismiss her, you also leave open the possibility that she will commit the same act at another practice because there will be no record for the community to see. I suggest you turn to an attorney and discuss how to proceed. WWW.PHYSICIANSPRACTICE.COM Q If we perform an EKG on a suspected or confirmed patient with Lyme disease, will we get paid from the insurance company as a legitimate procedure and, if so, how do we code? A Whether you get paid or not will depend on each payer. All you can do is code correctly. In this case, you’d code the EKG. You’d probably use 93000, routine ECG with at least 12 leads, with interpretation and report, but you'll want to review all the codes around this in your CPT book and report the one that reﬂects exactly the sort of testing you are doing. In addition, you’d report the ICD-9 for Lyme: 088.81. UNDERSTAND ECG CODES Q We have previously billed code 93224 for a 24-hour ECG study that included hook-up, recording, physician review, and interpretation. However, I’ve just been told we should be using 93268. Which is right? A You need to take a close look at the 2007 CPT code book and study the descriptions for these codes. You know better than we do what you are actually doing and charting. Brieﬂy, 93224 is for “electrocardiographic monitoring for 24 hours by FEBRUARY 2008 | PHYSICIANS PRACTICE | 57 http://PracticeSalesUSA.com http://PracticeSalesUSA.com http://WWW.PHYSICIANSPRACTICE.COM

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

Physicians Practice - February 2008 Contents The Bigger Picture: Your Future is in Your Hands Letters Physicians Practice Pearls: Creating an A+ Practice Noteworthy Cover Story: Conquering Time: 5 Keys to a More Efficient Practice In Balance: A Family Affair Technology: Making EMRs Work in the Exam Room In Practice: "I've Got Some Bad News" The Tech Doctor - The EMR: Savior or Poseur? Ask the Experts NEW! Healthonomics: How to Handle Health Savings Accounts The Administrator's Desk: Finishing School for New Managers Human Resources: Is Your Partner Impaired The Great Practice Makeover: Too Well-Liked for His Own Good? Coding Idealab: 'Why I Blog' Classifieds Advertiser Index

Physicians Practice - February 2008

For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.