by Tahlia Brody, CHP, VP of Customer Service TLD Systems
November 04, 2020
By tahlia@tldsystems.com
0 Comments
in order to be HIPAA Compliant, you must maintain a "Culture of Compliance" at your office. This can include keeping your software up-to-date, regular required training and addressing risks that pose to your office. This month we address HIPAA training, encrypting your drives and Business Associate Agreements
New Haven, Connecticut failed to terminate an employee’s access to their Health Records System after the employee left. The former employee may have accessed a file containing the Protected Health Information of only 498 Patients.
“I am reading conflicting information regarding the dispensing of a post-operative/cast shoe. Medicare never seems to pay for this but commercial carriers usually do. I am reading that this shoe is NOT separately payable when it is dispensed in conjunction with a surgical procedure code. You cannot have the patient sign an ABN and charge the patient for the shoe. Please clarify the dos and don’ts of using the L3260 HCPCS code.”
When providing Pneumatic Compression Devices (PCDs) to patients, be sure the
patient meets all Medicare coverage criteria. Recovery Auditors perform complex reviews on claims for
these devices to determine if the PCD is reasonable and necessary for the patient’s condition based on the
documentation in the medical record. Claims that do not meet the indications of coverage and/or medical
necessity will be denied. Affected codes are E0650, E0651, E0652, E0656, E0657, E0667, E0668, E0669
and E0670.
Hospital emergency department services are not payable for the same calendar
date as critical care services when billed for the same beneficiary, on the same date of service and by the
same service provider (based on Tax ID and Provider Specialty Code). Affected codes: 99281, 99282,
99283, 99284, 99285.
Aetna has agreed to pay $1,000,000 to the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS) and to adopt a corrective action plan to settle potential violations of the Health Insurance Portability and Accountability Act (HIPAA)
