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Do you know where your patient electronic data is stored? Legislature recently signed by Florida Governor Ron DeSantis amends the Florida Electronic Health Records Exchange Act (the Act) to reinforce the security of state residents’ electronic protected health information (ePHI). Although well-meaning, the law puts yet another level of risk on healthcare providers’ shoulders. Know […]
The post Florida Moves to Strengthen ePHI Safeguards appeared first on AAPC Knowledge Center.
Reimbursement for allergy testing services includes the following components,
Reimbursement for “allergy testing” is based on the number of each type of test performed by the same physician and is subject to the following limitations when the above coverage criteria are met,
Former owner of a chain of skilled nursing and assisted living facilities in South Florida faces a 20-year sentence after being found guilty of a decades-long scam of paying bribes and receiving kickbacks in a massive billion-dollar Medicare fraud and money laundering scheme. This extensive healthcare fraud conspiracy resulted in hundreds of millions of dollars […]
The post Florida Exec Sentenced to 20 Years in $ 1 Billion Healthcare Fraud Case appeared first on AAPC Knowledge Center.
Jaime L. Sepulveda, MD, LLC (d/b/a Miami Urogynecology Center), Jaime L. Sepulveda, M.D., and Sujata Yavagal, M.D. (collectively, “Miami Urogynecology Center”), South Miami, Florida, entered into a $ 173,768.08 settlement agreement with OIG. The settlement agreement resolves allegations that Miami Urogynecology Center submitted claims to Medicare for items or services that it knew or should have known were not provided as claimed and were false or fraudulent. Specifically, OIG contended that Miami Urogynecology Center submitted claims for: (1) diagnostic electromyography services using CPT code 51784 when therapeutic, not diagnostic, services had been provided; (2) pelvic floor physical therapy services using CPT codes 97032 and 97110 when those services were provided by an unqualified individual; and (3) evaluation and management (E&M) services using CPT codes 99213 and 99214 that were billed in conjunction with pelvic floor therapy procedures when no separate and identifiable E&M services were provided. OIG’s Consolidated Data Analysis Center and Office of Counsel to the Inspector General, represented by Senior Counsels Srishti Sheffner and Michael Torrisi, with the assistance of Program Analyst Mariel Filtz, collaborated to achieve this settlement.
The post Florida Physicians and Practice Settle False and Fraudulent Claims Case appeared first on The Coding Network.
Authorities at doctor administrations merchant EmCare in Florida have advised 60,000 patients, representatives and contractual workers about a cybersecurity occurrence that may have uncovered their own data. An unapproved individual had the capacity to get to various worker email accounts that contained clinical information and statistic data, alongside driver’s permit and Social Security quantities of certain people, as indicated by an examination.
The post Florida Physician reports a HIPAA Breach that could affect over 60K patients appeared first on The Coding Network.
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CPT 78492 is a Cardio imaging procedure and for its need more appropriate modifier should be obtained to indicate the clinical determination. suggested to send corrected claim with valid modifier for the CPT 78492.
DOS 02/11/2019.
We have billed only PET service for this DOS and no additional service billed on same day. Also patient does not have any global.
Can you anyone suggest what modifier require for this.
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Sheri D. Harwood, CPC, CMPE
Coding Supervisor
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Deanna L. Switalski, CPC
Another opioid pill mill gets busted by the Medicare Fraud Strike Force. A “pain management clinic” in Hialeah, Florida, owned by David Bosch and Tania Sanchez, which operated under the name East Medical Office Inc., unlawfully distributed thousands of pills of oxycodone, during the period of April 2017-May 2018. It was a cash-only clinic, which remained […]
The post Busted! Florida “Pain Management” Clinic Runs an Opioid Pill Mill appeared first on AAPC Knowledge Center.