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HIPAA
HIPAA Risk Analysis - Key to Saving Money
Syracuse ASC, also known as Specialty Surgery Center of Central New York, has been fined $250,000 to resolve violations of the HIPAA Security Law and Breach Notification Law. OCR was able to confirm that the incident was a ransomware attack using the PYSA variant. The data breach dates back to March 2021 where unauthorized access to ePHI of a reported 24,891 patients. The threat potentially stole names, birth dates, Social Security numbers, financial data, and clinical information. The breach was not reported to the affected individuals until October 2021.
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FDA Recalls
Coding
Coding Pearls - Using the 58 Modifier Appropriately Modifier 58 v Modifier 78
My associate doctor recently billed for a hospital outpatient surgery: 28005 and 11981.
The antibiotic spacer kept displacing during the p/o period, so he went back earlier than expected to do the following, hence the patient is still in the post operative global period from the first set of procedures:
28755 -- 58,RT -- M10.9
20705 -- 58,RT -- M86.9
11750 -- 79,T5 -- L60.0
Is this coded correctly with regard to modifiers and diagnosis codes? I personally have never done a staged procedure, and I know my billing company probably won't know either, so I figured I'd ask here first before submitting and getting hit with denials.
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FDA Recalls
HIPAA
Minneapolis VA Medical Center Data Breach
The Minneapolis Veterans Affairs Medical Center has experienced two distinct and significant data breaches within a seven-month period, revealing multifaceted vulnerabilities in its data protection protocols.
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Coding
Coding Pearls - Akin Osteotomy Denials
“Has anyone had CIGNA, Tufts, UHC reject CPT code 28310 (Akin osteotomy) as a separate and billable code with a Lapidus arthrodesis/hallux valgus correction with bunionectomy (CPT 28297)? I did appeal with CIGNA and was told that the nurse-coder looked at my appeal and related to me that according to the NCCI Edits, the Akin osteotomy is “part and parcel” included with a Lapidus arthrodesis/ bunionectomy. What is the next step?”
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