of Contract Negotiations of Contract Negotiations - AAPC

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August 2012

The Big Picture of Contract

Negotiations

Marcia Brauchler, MPH, CPC, CPC-H, CPC-I, CPHQ

Plus: HCC • Word on ICD-10 • Risk Adjustment • Ultrasounds • E/M Modifiers

NAMAS 4th Annual Auditing Conference

Conference held at Grove Park Inn, Asheville, NC December 3-4, 2012

The ONLY National Conference that is AUDITING SPECIFIC Preconference Events Include: “Hands-on” Specialty-Specific Auditing CPMA® Training Course Training for Effective Managed Care Negotiations This month’s conference special is: Bring your physician for 1/2 Price! Purchase a ticket to the conference and bring your physician for only $495!

Visit our website for more details!! www.NAMAS-Auditing.com or call 877-418-5564

Conference Agenda Provides two tracks each day. During each session the attendee will chose from: General topics relevant to all fields of auditing Specialty-specific auditing breakout sessions General Sessions relevant to all auditors and include speakers such as: Shannon DeConda, President of NAMAS Sean Weiss, VP of Decision Health Kelly Custer a well-known Fraud & Stark Attorney Expert For a complete listing of sessions, please visit our website www.NAMAS-

This 4th Annual conference is being supported by:

HSM Customers should inquire with their Representative for additional conference discounts that may apply

Contents

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[contents]

August 2012

In Every Issue 7 Letter from the Chairman and CEO 9 Letter from Member Leadership 10 Letters to the Editor

Contra ct

10 Kudos

Negotia

13 Coding News

tions 29

Features 18 Strengthen Your Diagnosis Coding for Risk Adjustment

Serine A. Haugsness, CPC

20 Coding from EHRs: It’s Documented, but Did It Happen?

Erin Andersen, CPC, CHC

Special Features 12 Quick Tips: Morton’s Neuroma, PMDD 16 Hot Topic: Wellness Visits 41 ICD-10 Roadmap: Word is … 50 Minute with a Member

Education

22 Bedside Ultrasounds: Take a Closer Look

14 AAPCCA: Chapter Speakers



15 Handbook Corner: Smartphones

Sarah Todt, RN, CPC, CPMA, CEDC

24 Factor HCC with a Two-pronged Approach to Risk Adjustment

Holly J. Cassano, CPC

26 Practice Managers Succeed with Practical Know-how

Dixon Davis, MBA, MHSA, CPPM

29 The Big Picture of Contract Negotiations

Marcia Brauchler, MPH, CPC, CPC-H, CPC-I, CPHQ

34 Identify the Correct Global Period E/M Modifier

Nancy Clark, CPC, CPC-I

38 It’s Time to Re-evaluate Your E/M Coding Suzan Berman, CPC, CEMC, CEDC

45 A&P Quiz 47 Newly Credentialed Members Online Test Yourself – Earn 1 CEU

Go to: www.aapc.com/resources/ publications/coding-edge/archive.aspx

Coming Up • PT/OT • Surgical Modifiers • Colonoscopy

On the Cover: Physicians’ Ally, Inc. is lined up at the box office of the Paramount Theatre in Denver, Colo. to see Marcia Brauchler’s big picture, “Payer Contract Negotiations.” Cover photo by Brian Kraft Photography (www.briankraft.com).

• EHRs that Code • Acronyms www.aapc.com

August 2012

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Serving 116,000 Members – Including You!

Be Green!

August 2012

Why should you sign up to receive Coding Edge in digital format?

Chairman and CEO

Here are some great reasons:

Reed E. Pew [email protected]

• You will save a few trees.

Vice President of Finance and Strategic Planning Korb Matosich [email protected]

• You won’t have to wait for issues to come in the mail. • You can read Coding Edge on your computer, tablet,