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3 new codes simplify your vaccine coding Does Interpreting HIPAA Delay Justice? Confidentiality Rules Cut Out Surgeon-Shopping Medicare Chief Steps Down Thousands Of Providers Ousted From Medicare Report Multiple Vaccines With 90698 and 90715 3 new codes simplify your vaccine coding
New code 90734 (Meningococcal conjugate vaccine, serogroups A, C, Y and W-135 [tetravalent], for intramuscular use) adds more specificity to your physician’s meningococcal vaccinations, because the code states a specific serogroup of meningococcal. For instance, you would use 90734 when the physician vaccinates a patient for meningococcal serogroups A, C, Y and W-135. On the other hand, you would report established code 90733(Meningococcal polysaccharide vaccine [any group(s)], for subcutaneous use) when the physician treats a patient with polysaccharide vaccine for any group of meningococcal disease. Back to Top of Page Does Interpreting HIPAA Delay Justice? BOSTON (HIPAA WIRE) An eight-week-old at Tufts-New England Medical Center is in a coma after his 21-year-old father allegedly abused him, and when police officers came to the Center to question doctors about the child’s injuries, they were welcomed with an alarming silence. Hospital officials cited privacy laws as the reason they could not disclose the child’s condition to the officers responsible for investigating the alleged crime. Officers were dumbfounded at the lack of cooperation in the case: “This is a potential homicide. So we’re up there trying to figure out what happened. What the injuries were, who may have caused them. And the doctor can’t talk,” said Frank Middleton Jr., Plymouth assistant district attorney, according to the Boston Herald. And other law enforcement officials in the Boston area agree that HIPAA is having an adverse effect on their investigations; they claim the combination of confidentiality rules and fears of litigation have mired efforts to prosecute certain criminal cases - especially child abuse cases, the Herald reports. In the case of the alleged child abuser, a potentially guilty parent could get away unprosecuted, since prosecutors say patient privacy laws prevent them from collecting evidence against the suspect. Meanwhile, the hospital blames the state’s privacy laws, and the state Department of Social Services (DSS), which is telling it not to disclose any information. The DSS says it allowed police interviews with doctors as fast as it could. The district attorney’s office in Plymouth said it plans either to hammer out voluntary agreements with hospitals regarding disclosures needed for criminal investigations, or to champion a change in the privacy laws, if necessary. To read the article in its entirety, click here. Back to Top of Page Confidentiality Rules Cut Out Surgeon-Shopping DES MOINES, IA (HIPAA WIRE) A man in need of a spine and brain operation claims confidentiality laws prevented him from seeking competent surgical aid. Unbeknownst to the public at the time, surgeons at Des Moines’ Mercy Medical Center complained that Dr. Dan Miulli was unqualified to perform complicated surgical procedures, and claimed that legal documents would reveal this lack of qualification. Miulli’s colleagues had also reported him to state regulators, who began an investigation more than a year before Dennis Cawthorn’s surgery. Cawthorn’s surgery was a failure and left him incapacitated and in permanent pain, the Des Moines Register reports. While Miulli has denied claims of incompetence, Cawthorn and several other patients are suing Miulli for the latter’s alleged incompetence. “If we’d had any idea [of Dr. Miulli’s incompetence], we would have gotten another doctor,” Cawthorn said. Patients have no access to a national databank that tracks doctor records, nor do they have a right to access any data pertaining to internal hospital investigations. On only rare occasions can patients learn whether doctors have paid to settle malpractice lawsuits, according to the Register. For now, physicians’ peer review process is also confidential, yet Dr. Tom Evans, president of the Iowa Medical Association, said he expects the process to be replaced with a more open system that allows consumers to judge the quality of hospitals and doctors. “What we currently operate under is a culture of blame and punishment. We don’t have openness,” said Evans, the Register reports. Evans says health care leaders in the state currently are designing methods to measure how well patients recover depending on who cares for them, but that process is difficult to accomplish without penalizing doctors for understandable blunders or unpreventable outcomes. Dr. Sidney Wolfe, a national activist for the group Public Citizen, said he’s frustrated that even as a physician he cannot determine the track record of medical specialists to whom he might refer patients. Wolfe told the Register that the medical profession is protecting the relatively small number of faulty doctors who cause the majority of malpractice injuries and deaths. “The ones who have never been sued are subsidizing the ones who have had five or seven payouts,” he said. “The facts should come out.” To read the article in its entirety, go to http://desmoinesregister.com/life/stories/c4788996/22914749.html Back to Top of Page Medicare Chief Steps Down BALTIMORE (Hospital Compliance Wire) The top dog at the Centers for Medicare & Medicaid Services is calling it quits after two years and nine months at the post. It’s been well known in Washington that CMS Administrator Tom Scully was ready to step down from his post and on Dec. 3 he made it official, announcing that he’s resigning effective Dec. 15. The move comes right on the heels of the passage of the Medicare reform/prescription drug bill, for which he was a key Bush administration champion. “Watching the president and [Health and Human Services Secretary Tommy Thompson] drive the Medicare bill across the finish line in the last few weeks was a very rewarding culmination to a very exciting and fulfilling three years,” Scully says. Scully has been in contact with a number of law and investment firms in recent months and stands to secure a lucrative post at one of them. Back to Top of Page Thousands Of Providers Ousted From Medicare WASHINGTON (Hospital Compliance Wire) The going remains tough for health care providers who run afoul of Medicare and Medicaid fraud fighters. For the fourth government fiscal year in a row, more than 3,000 individuals and organizations were excluded from federal health care programs, according to the HHS Office of Inspector General’s latest semiannual report. The OIG also boasts 576 convictions for fraud and other misconduct, up from 517 last year, and 243 new civil suits under the False Claims Act and other laws, up from 236 in 2002. The monetary haul from fraud investigations in 2003 was $988 million - down significantly from the $1.49 billion secured in 2002. On the other hand, the OIG says the total amount it saved the government - through fraud probes, audits, and cost-saving recommendations - reached a record $23 billion in 2003. To see the report, go to http://oig.hhs.gov/publications/docs/semiannual/2003/03fallsemi.pdf Back to Top of Page |
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