Practice Management

Should the cuts take place as planned, 18 percent of physicians surveyed by the American Medical Association say they would stop accepting new Medicare patients; 57 percent would decrease time spent with patients; and 46 percent would reduce staffing levels.

Most dermatology billers are relatively comfortable (or should be) with the various modifiers commonly used by dermatologists (e.g., -24, -25, -26, -58, -59, -76, -79, -GA, GY, and -TC. Less familiar are modifiers -50 and -52.

Key features of the plan, which the division has been refining over the past four to five years, include sharing profits — and risks.

National report — Clinical research investigators need to be aware of their numerous responsibilities to sponsors, patients, the public and, sometimes, the government. Complying with rules might be more important than ever, given the recent media attention focused on problems surfacing with some medications years after they have been approved and on the market.

Modifiers, modifiers, modifiers! Wouldn't life be great if we didn't have to deal with all those two-digit devils? Why can't we just send a claim to the insurance company and get paid without trying to figure out which CPT code gets a modifier, which one doesn't, and, if one is needed, which one should be selected? Worse yet, in many instances, we need two, three and, yes, sometimes even four modifiers. There are -24, -25, -58, -59,-76, -79, just to name a few. Then there are those darn local modifiers like -GA, -GY and -GZ. Gee whiz, is more like it!

Miami — No doctor would treat a patient as haphazardly as many seem to treat their practices. From improper coding to trust placed in the wrong people, many physicians' practices suffer from a variety of treatable ills, according to Mark S. Nestor, M.D., Ph.D., director, Center for Cosmetic Enhancement, and clinical associate professor of dermatology and cutaneous surgery at the University of Miami School of Medicine, Miami.

Dr. Jane is one of the most caring dermatologists in her community. She has practiced dermatology for more than two decades and has seen many of her patients become quite elderly. She is saddened by the senility of some and is worried about their ability to consent to her various office-provided procedures. One of her patients with Alzheimer's disease has a brother who is the next of kin and holds a medical power of attorney that becomes effective when the described patient is no longer able to make decisions for himself. Dr. Jane has a copy of that power of attorney. She is often perplexed because, at almost all times, the patient is not lucid. However, in rare moments, he does understand what Dr. Jane is doing.

Although most dermatologists try to stay away from treating nails and nail diseases, it's inevitable that patients will receive services for treating the nail and nail-related problems.

The photos have been sorted from more than one million images provided by collections at New York University, University of Rochester, and private collections.

Clay J. Cockerell, M.D., assumes the post of AAD president tomorrow.

By now, most practices are familiar with Medicare's Correct CodingInitiative (CCI) introduced by CMS in 1996.

Kissimmee, Fla. — Recent changes in Medicare and CPT coding have brought some good news to dermatologists, says Brett Coldiron, M.D. Speaking at the Orlando Dermatology & Cosmetic Conference, he updated attendees on developments relating to Medicare audits and billing for surgical excisions.

Washington — How the new, more conservative, more Republican Congress and the Bush administration deal with several key issues will have a very direct and significant impact upon how dermatologists practice medicine in the coming years.

The waiting time to see dermatologists has been increasing, significantly. In the U.S., it is 36 days for a new appointment, and in Texas it is 34 days.

Although everyone in the medical billing environment tries hard to follow all the rules set forth by the many managed care plans, the American Medical Association, Children's Medical Services, the Office of the Inspector General, as well as State and Federal statutes, mistakes do occur.

Washington - As the federal government considers a regulation to implement the 2005 Medicare physician fee schedule under the new Medicare Modernization Act (MMA), many specialty groups - including dermatology - are concerned that physician fees will suffer unless some specific problems are fixed.

Many reliable sources will be providing physicians and staff input regarding all the changes set forth by the American Medical Association (AMA) and the Center for Medicare & Medicaid Services (CMS) for fiscal year 2005. Based on the display copy of the Nov. 2, 2004 Federal Register, the 2005 AMA CPT book, and the ICD-9-CM Book for 2005 published by the World Health Organization, pertinent changes for dermatology practices are summarized below:

For the past few months, I have been a part of an arbitration panel of physicians, hired by an organization that gives independent opinions concerning claims for reimbursement for medical providers, pre-authorization issues and quality of care issues.

Incision and drainage services are commonly performed dermatologic services; although, they are frequently billed incorrectly causing unnecessary denials and reviews.

Cross training is good for the physician, because it provides more flexibility in managing the efficiency of the practice when employees are absent.

New York - When Joseph S. Eastern, M.D., started practicing in the early '80s, if physicians' practice income didn't cover their office expenses, they raised their fees. Changes came about in the 1990s with the proliferation of managed care. Insurance companies started dropping fee-for-service insurance plans in favor of reimbursement caps, or negotiated lower fees - often based on reduced reimbursements authorized by Medicare.

Dermatologists want to hear more specific plans for healthcare from both candidates.

Security is the most critical component. Does the e-mail package you're considering meet the 2005 HIPAA guidelines for patient privacy and security? And does the hosting company have the ability to safely share files between two or three offices?

Boston - Improvements on a non-invasive alternative to liposuction may revolutionize medical procedures in this area, according to a presentation at this year's International Master Course on Aging Skin.

With so much emphasis over the past year on HIPAA and concerns about the downward spiraling reimbursement rates from Medicare and commercial insurance carriers, very little attention has been focused on internal auditing and compliance efforts.

New York - Doctors should periodically review the parameters of all the insurance plans to which they belong to see if any are not keeping step with the others.

Although most everyone in billing is generally very comfortable with ICD-9-CM diagnosis coding, it's still not uncommon for me to receive faxes that demonstrate that there is still some bad coding going on in dermatology practices.

Dr. Ron has finally learned to deal with all the new privacy requirements of HIPAA. He provides reasonable confidentiality to his patients and his privacy statement to patients is in full compliance with the law. His computers and vendors are all HIPAA compliant. His attorney assures him that his office is now HIPAA compliant.

Providence, R.I.-Access to dermatologists by many patients who most need the care-the indigent-is so critically limited that a solution to the problem must be found, concludes a study presented at the recent meeting of the Society for Investigative Dermatology.

Rates double; claims rise; some doctors ‘go bare’; specialty faces new scrutiny