- Helping you with HIPAA Security Solutions.
News
HIPAA
The Importance of Audit Controls
Did you know that your certified EHR has audit logs? Other software that your office uses may also have audit logs. You can enable audit logs to track activity on your network and on your computers.
Read More
FDA Recalls
Coding
OIG Auditing Podiatrists for Evaluation and Management Services
In 2019, the OIG performed an audit of claims that were billed by podiatrists for E/M services. The audit examined whether podiatrists’ claims for E/M services billed with the 25 modifier, which indicates that the E/M service was significant and separately identifiable from a minor surgical procedure billed on the same date of service, one that has a postoperative global period of 0 or 10 days, complied with Medicare’s guidelines. One hundred (100) claims were sampled, and it was found that forty-four (44) claims did not comply with Medicare’s guidelines. The OIG estimated that $39.6 million of the $222.5 million paid by Medicare during the audit period was inappropriate. It was found that during the audit period, CMS’s oversight may not have been sufficient to prevent improper payments.
Read More
HIPAA
HIPAA is to Protect the Patient
I’d like to share a personal experience that has made me so grateful to have HIPAA. I understand and sympathize with that burden HIPAA places on providers and practices. At TLD Systems we do our best to minimize that burden, educate you about your responsibilities and help you to meet the HIPAA requirements. My experiences reminded me that HIPAA is about protecting patents, and at some point we are all patients.
Read More
FDA Recalls
Coding
Cigna Denials Cigna Denials
I have a patient with diabetic peripheral neuropathy and foot ulcers. I have been debriding the ulcers every two weeks, and we have billed out CPT 11042. Cigna has denied our latest two claims and the EOB says, “Procedure code is invalid for DOS and global.” There is no global for CPT 11042 and there should not be a procedure code invalid for any DOS with these claims. Any thoughts on what to do next?
Read More