Cardiovascular Business - July/August 2008 - (Page 29)

9% 42% ‘Bad Coding’ Tops Medicare Reclamation List incorrectly Coded Medically Unnecessary Service or Setting other no or insufficient documentation Medicare recovery contractors (RACs) collected more than $350 million in Medicare overpayments to providers. Incorrect coding accounts for nearly half. 17% 32% She stresses that educating both staff and physicians is key to understanding the complicated cardiology coding rules for procedures. But understand they must. Back-of-the-envelope calculations suggest that if all 250,000 units of service were underbilled by two levels, with an average Medicare difference of $75, the practices were losing $18 million dollars annually. A new wrinkle to the equation is the recovery audit contractors (RACs), private companies contracted with Medicare to recover overpayments as well as underpayments. The program became official this year after Medicare recouped nearly $440 in overpayments to providers during the twoyear pilot phase (see sidebar, page 28). Amato says that practices have to be particularly vigilant. “I caution practices that if something looks odd to me, it could look odd to the RACs and other people who do extensive analysis with sophisticated software,” she says. or unrealized. She created a procedural coding spreadsheet log that is updated on a daily basis from information gathered via faxes and/or phone calls received from the various sites of service. Coders also perform checks and balances for diagnostic reads from patient logs. They can generate a computer report for any services performed in the office. The compliance officer completes routine dictation audits of the physicians and Leave the Counting to Us Coding vigilance The cardiology coders and staff at Wellmont Holston Valley Hospital, a 400-bed facility in Kingsport, Tenn., are constantly training, says Tammy Gott, CPC, chief coder in cardiology and cardiac and thoracic surgery for Cardiovascular Associates, a 29-physician practice. “We have access to several medical publications and our company sponsors numerous webinars, teleconferences and travel opportunities for training seminars,” Gott says. She has two other full-time coders and one in apprenticeship. One coder handles only Medicare claims, including denials and explanation of benefits. Gott won’t hire anyone who is not a certified professional coder and she looks for proficiency in EP and peripheral vascular. Gott occasionally conducts phone consultations at the request of other practices and the predominant concerns right now are coding for peripheral vascular disease and EP procedures. “You ask anyone, coders proficient in those two areas are worth their weight in gold,” she says. Gott made the decision to code directly from the report after an audit revealed hundreds of thousands of dollars being missed because the submitted charges were incomplete and/ With WaveMark CIMS you’ll always have what you need WaveMark CIMS captures inventory and usage information in real-time with RFID-enabled cabinets and bins. Information is available via a web browser empowering hospitals to intelligently set target inventory levels, manage expiring products, track lot and serial #s, identify usage patterns, provide accurate charge capture, optimize bulk buys, and more. A web-based solution with a low monthly service fee, means no capital expense or up-front fees. Call 877-4WAVEMARK, or visit us at “With WaveMark we are now able to reduce the manual work of inventory tracking.” —Halsey Bagg, Director, Cardiac Services www.wavemark.net CardiovascularBusiness.com Cardiovascular Business 29 http://www.wavemark.net http://www.wavemark.net http://CardiovascularBusiness.com

Table of Contents Feed for the Digital Edition of Cardiovascular Business - July/August 2008

Cardiovascular Business - July/August 2008 Table of Contents First Word Cover Story: Planning for the Ideal Cath Lab Requires the Multidisciplinary Approach Clinical Study Digest: Cell Phone Technology Speeds Ecgs As Real-Time 3d Echo Matures, It Finds a Clinical Niche Ecg Image Management Brings Increased Productivity and Confidence Overcoming Barriers to Cath Lab Inventory Control Maximizing Reimbursement, Minimizing Penalties News & Views Calendar Reader Resources The Back Page

Cardiovascular Business - July/August 2008

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