When you received your 2016 Current Procedural Terminology (CPT) and American Society of Anesthesiologists (ASA) Relative Value Guide (RVG) books or discs, you probably noticed there were no new anesthesia code additions or deletions listed for this year. Since the CPT book usually arrives before the RVG, you may not have taken a good look through your RVG or may not have ordered a 2016 RVG as there were no coding changes. However, there are a number of important updates in the RVG New/ Revised RVG Coding Comments section which are not included in the Anesthesia section of the CPT. These comments may affect the way anesthesia coders assign procedure codes in the upcoming year. As this article will not include all updated comments, be sure to order your 2016 RVG. I’ve chosen a few that are certain to have an impact on 2016 coding for anesthesia services. Let’s start with...

The American Pain Society (APS) last month released its first-ever Clinical Practice Guidelines on the Management of Postoperative Pain.  The American Society of Anesthesiologists, which published its own Practice Guidelines for Acute Pain Management in the Perioperative Setting in Anesthesiology in 2012, provided input, and the American Society for Regional Anesthesia endorsed the APS Guidelines. "The intent of the guideline is to provide evidence-based recommendations for better management of postoperative pain, and the target audience is all clinicians who manage pain resulting from surgery," said principal author Roger Chou, MD of the Departments of Medicine and Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Pacific Northwest Evidence Based Practice Center.  (APS News Release, February 17, 2016.)  Studies have shown again and again that the majority of surgical patients receive inadequate pain control, which can increase the risks of persistent postoperative pain and of post-surgical complications, function and functional recovery,...

We all know that the healthcare industry is experiencing a wave of integration. This trend has been evident for many years. Fewer physicians are willing to assume the legal, financial and other business risks associated with owning their own practices. More and more physicians, including anesthesiologists, are becoming employed by large physician groups, health systems and national providers. This shift necessarily involves not only entry into new employment arrangements but also the termination of existing relationships. And those terminations are often governed by written employment agreements, state and federal healthcare laws and employer benefit plans and other policies and procedures. Before pursuing their next opportunity, physicians should pause for a moment and first attend to the arrangement that they are leaving. Departing physicians need to understand their legal rights and obligations when leaving their current employment relationships in order to avoid unintended consequences and detrimental missteps along the way. Here are...

“Ransomware” attacks are malicious intrusions into information systems that encrypt the victim’s sensitive data and demand payment in exchange for a key to unlock the data.  They have become increasingly common in the last few years.  Since January 2013, there have been at least 100,000 cases of recorded ransomware attacks. The installation of such malware on third parties’ computer systems is usually paired with a demand for payment by a certain deadline or the computer data will be deleted.  This is a more direct means for criminals to realize profits from hacking into hospital systems than selling medical records.  It is also a more immediate, direct threat to patient welfare.  On February 5, 2016, Hollywood Presbyterian Medical Center in Los Angeles became one of the latest and highest-profile victims, demonstrating that “ransomware should be a permanent concern for anyone or any business using the internet, and it’s going to get worse...

The Affordable Care Act requires Medicare physicians and others to report and return overpayments within 60 days after the date when an overpayment is identified.  Four years after publishing its proposed rule, CMS issued a Final Rule on February 6, 2016 with the intent of providing “needed clarity and consistency for providers and suppliers on the actions they need to take to comply with requirements for reporting and returning of self-identified overpayments.” Identification of an overpayment starts the clock for the repayment deadline of 60 days.  The most significant point of clarification in the Rule is that “identification” of an overpayment occurs when “the person has, or should have through the exercise of reasonable diligence, determined that the person has received an overpayment and quantified the amount of the overpayment."  Applying this principle may seem to require little explanation but CMS managed to spend nine pages discussing it in the Federal...