The Centers for Medicare and Medicaid Services (CMS) recently implemented major changes to the Stark Law regulations, most of which are already in place. However, some health care providers may be less aware of the changes to the “special rule for productivity bonuses and profit sharing” within Stark’s group practice definition.
Read MoreWe are undeniably in uncertain times and uncharted territories. The medical world and the world at large has been thrown into upheaval in an attempt to weather and survive the COVID19 pandemic. Arguably, no industry has been affected more so than the medical industry; even-more the musculoskeletal specialities such as orthopedics and radiology have been virtually shut down. Elective surgeries had been canceled to free up space for COVID-19 patients.
Read MoreRadiology Revenue Cycle Management Orthopedics Certified Professional Coder Practice Management Billing & Reimbursement
The descriptions for intermediate and complex repairs have been clarified
including adding the description for limited and extensive undermining.
Intermediate Repair- Intermediate repair includes the repair of wounds that,
in addition to the above, require layered closure of one or more of the deeper
layers of subcutaneous tissue and superficial (non-muscle) fascia, in addition
to the skin (epidermal and dermal) closure. It includes limited undermining
(defined as a distance less than the maximum width of the defect, measured
perpendicular to the closure line, along at least one entire edge of the defect)
Single-layer closure of heavily contaminated wounds that have required
extensive cleaning or removal of particulate matter also constitutes
intermediate repair.
Complex repair- Complex repair includes the repair of wounds that in
addition to the requirements for intermediate repair, require at least one of the
following; exposure of bone, cartilage, tendon, or named neurovascular
structure; debridement of wound edges (e.g. traumatic lacerations or
avulsions); extensive undermining (defined as the distance greater than or
equal to the maximum width of the defect, measured perpendicular to the
closure line along at least one entire edge of the defect); involvement of free
margins of helical rim, vermillion border, or nostril rim; placement of
retention sutures. Necessary preparation includes creation of a limited
defect for repairs or the debridement of complicated lacerations or avulsions
Scar revision has been removed from the description of complex repair.
Per the AMA, Scar revision in which skin is excised and closure is
performed should be coded as excision of benign lesion. This code will be
considered included in most other surgical procedures.
Running an orthopedic practice, or any medical practice for that matter, requires a delicate balance of business and clinical expertise. Orthopedists want to focus on providing the highest quality medical services possible, but at the end of the day, they also have a business to run. This can cause several issues within the orthopedic practice. Today, we will go over some of the most common business challenges for orthopedic practices and how to go about managing these problems.
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