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HIPAA
Recognizing Common HIPAA Violations and How to Prevent Them
In 2024, the most common HIPAA compliance issue, according to the Office for Civil Rights (OCR), remains the impermissible use and disclosure of protected health information (PHI).
When violations are identified, the OCR frequently refers cases to the Department of Justice (DOJ) for further action. As of 2024, 2,419 referrals have been made to the DOJ for criminal investigation.
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Coding
Coding Pearls - Audit Of L1951
“I have had a RAC audit for a L1951 (from performant) claiming an overpayment stating, “the custom- fitted orthosis did not include a detailed description of the necessary modifications.” L1951 is a prefab which does not require modifications. Where can I go to get any documents (Medicare preferred) stating that L1951 is prefab and as such does not require modifications to respond to this demand?”
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FDA Recalls
MIPS
REGCLR1 Heel Pain
REGCLR1 measures the improvement in function of the patients with a diagnosis of Heel Pain that have a reduction in pain after an intervention. No specific treatment is required to meet this measure; it simply requires a significant decrease in the patient's pain as a result of your intervention. Treatments may include custom orthotics, prefabricated orthotics, injections for heel pain, night splints, stretching, and physical therapy.
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Coding
Coding Pearls - Coding For Multiple Complaints
“Can I bill a level 4 E/M code if a patient presents with multiple unique, separate identifiable complaints that I am treating? For example: A patient comes in with complaints of a hammertoe and plantar fasciitis. I am treating both. Can I code a level 4 code and be justified based on the time?”
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FDA Recalls