V&A Articles | Lalawfirm

Feb 12, 2018

Medicare Follow-up Regarding Genicular Blocks

In the article we wrote this morning about the AMA's changed position on genicular nerve RFs, I need to distinguish between Medicare and...

Jan 28, 2018

Back and Knee Braces Hit the OIG's Work Plan

This month the OIG just updated its "Work Plan" for 2018 by adding "Off-the-Shelf Orthotic Devices" to the Work Plan. The OIG will...

Jan 16, 2018

2018 Changes to ASA Crosswalk and RVG

1. Changes to ASA Crosswalk. There were a number of changes in the 2018 version of the ASA's Crosswalk. Many were not significant, but...

Jan 16, 2018

2018 Base Unit Values- ASA RVG vs. CMS

The list below contains anesthesia codes where the base unit values are different in the ASA RVG when compared to CMS for 2018. All...

Dec 17, 2017

Recap of 2017 HIPAA Cases and Guidance

In 2017, the OCR assessed fines and exacted settlements in 10 cases that it reported on its website, and also issued new guidance on 5...

Dec 11, 2017

What's New in Chronic Pain for 2018

UDT Confirmation Reimbursement. Medicare reimbursement for confirmation codes G0480-83 will be reduced 10% per year for the next 3...

Dec 11, 2017

The Colonoscopy Conundrum

1. Code Deletions and Additions. For 2018, ASA codes 00740 (upper GI) and 00810 (lower GI) are deleted, and in their place are 5 new...

Oct 4, 2017

Reduced UDT Rates Proposed by CMS

On September 22, 2017, CMS released a proposed material reduction to the Clinical Laboratory Fee Schedule (“CLFS”), affecting urine drug...

Sep 5, 2017

Stopping Medicare Recoupment on Appeal

Medicare released a new MedLearn Article (MM9815) on September 1, 2017 clarifying the rules on stopping Medicare from recouping money...

Jul 5, 2017

New QMB Guidance

On June 28, 2017, Medicare issued an amendment to the QMB (Qualified Medicare Beneficiary) rules. It is illegal to bill a QMB (patient...

Jun 9, 2017

New Guidance from OCR on Cyber Attacks

On June 8, 2017, the OCR released 2 documents designed to instruct CEs (Covered Entities) and BAs (Business Associates) what to do in the...

Apr 25, 2017

2017 HIPAA Settlements To Date

During 2017, the following HIPAA settlements have occurred. 1. $475,000 for an untimely notification to the OCR of a breach. Under the...

Mar 17, 2017

Update of Lab Reporting for POLs

This is an update to our March 1, 2017 article titled “Lab Reporting Requirements to CMS.” This update is due to changes made by CMS last...

Mar 1, 2017

Lab Reporting Requirements to CMS

The deadline for physician office labs and independent labs to report their private payor rates to CMS began on January 1, 2017, ends on...

Jan 11, 2017

$475,000 Fine for Untimely Breach Notification

1. Breach Notification Rule. On January 9, 2017, DHHS issued a press release assessing a penalty - for the first time - for the failure...

Dec 27, 2016

MIPS (Merit-Based Incentive Payment System)

Although most of this article relates to how MIPS operates for both anesthesia and chronic pain providers, there are parts that are...

Dec 13, 2016

What's New in Anesthesia for 2017

1. What’s Not New. There are no new anesthesia codes. There are no modifications to the existing anesthesia codes, although there is a...

Dec 12, 2016

What's New in Chronic Pain for 2017

**This article was revised to correct the descriptions of the new interlaminar epidural codes that were incorrectly defined in the...

Dec 7, 2016

CMS Requires Surgeon to Document Reason for Post-op Pain Block

Chapter 2 of the National Correct Coding Initiative states, “Postoperative pain management services are generally provided by the surgeon...

Sep 29, 2016

Billing Psychological Tests under CPT code 96103

Many pain groups bill 96103 for computerized testing of patients. The scope of what constitutes a valid use of 96103 has been in...

Sep 29, 2016

May a Billing Company Withhold a Client's PHI?

The last sentence of the prior article was partially incomplete. This is the corrected version. The OCR recently released a FAQ...

Sep 6, 2016

Coding a Fascia Iliaca Acute Pain Block

The AMA has provided guidance as to how to code a fascia iliaca acute pain block. Based on the anatomy involved, and physicians'...

Sep 6, 2016

FCA Liability for Too Many Drug Confirmations

On August 31, 2016, the U.S. Attorney's Office for the Middle District of Florida issued a press release stating that Coastal Spine and...

Jul 20, 2016

$2.7 Million HIPAA Settlement

Oregon Health & Science University (OHSU) has agreed to pay $2.7 million to the OCR for 3 HIPAA violations that it self-reported,...