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Acute Pain Management: The CPT Coding Challenge for Anesthesia

SummaryThe growing use of nerve blocks for acute pain management is helping anesthesiologists improve the quality and safety of patient care. New approaches and techniques are emerging all the time. While this innovation benefits patients, it also creates billing and coding challenges and underscores the importance of having a billing partner that ...
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Burnout in Anesthesia: Targeting Causes, Solutions and Prevention

Physician burnout—including burnout among anesthesia providers—remains a serious public health problem, with studies showing prevalence rates of approximately 50 percent. A recent study in the Journal of Internal Medicine calls for a two-pronged blend of individual and organizational solutions, arguing that "addressing physician burnout should be v...
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Anesthesia and Pain Clinicians: Know When—and When Not—to Issue an Advance Notice of Noncoverage

When an anesthesia or pain management service that is usually covered by Medicare or another insurer may not be covered in a given circumstance, practitioners must issue an advance beneficiary notice (ABN) describing the services and informing the patient of their potential financial responsibility if they choose to proceed. Failure to appropriatel...
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Artificial Intelligence and Machine Learning in Anesthesia: Are We There Yet?

Within five years, more than half of hospitals will have begun using artificial intelligence, including machine learning, to support clinical care and business functions, a survey has found. We offer current information on the emerging technology's expansion and acceptance in medicine and healthcare, along with insights on potential applications in...
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The Winning Strategy for Billing Invasive Monitoring

When the ASA Relative Value Guide (RVG) was first developed in the 1970s it established a significant precedent with regard to what services could be billed as incidental to an anesthetic. The guide established the concept of "invasive" as the critical criterion.Arterial artery catheters, known as A-lines; central venous catheters; and Swan-Ganz ca...
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CMS’s 2019 Anesthesia-Related Payment Proposals for Outpatient and Ambulatory Services

SummaryThe proposed rule for the Outpatient Prospective Payment System and the Ambulatory Surgery Center Payment System for 2019 includes proposals to change payment policy for non-opioid postsurgical pain management drugs, expand reimbursement for anesthesia services for some knee surgeries to outpatient settings and remove questions about pain co...
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Becoming a Cheetah and Other Survival Tactics

In her blog, A Penned Point, early this year, Karen Sibert, MD, president of the California Society of Anesthesiologists, asked her fellow specialists to take some time during Physician Anesthesiologists Week to celebrate the specialty's accomplishments, but also to reflect on the state of the profession today, the anesthesiologist's place in the c...
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Will Anesthesia Providers be Targeted in CMS’s ‘Probe and Educate’ Audits?

SummaryTargeted Probe & Educate, a medical review process introduced by the Centers for Medicare and Medicaid Services in late 2017, identifies providers with high claim error rates or unusual billing practices for items and services that pose the greatest financial risk to Medicare. We present an overview of the process, which focuses on educa...
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The Winning Strategy for Billing Invasive Monitoring

Kelly D. Dennis, MBA, ACS-AN, CANPC, CHCA, CPC, CPC-I Perfect Office Solutions, Inc., Leesburg, FL When the ASA Relative Value Guide (RVG) was first developed in the 1970s it established a significant precedent with regard to what services could be billed as incidental to an anesthetic. The guide established the concept of "invasive" as the critica...
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CMS’s 2019 Proposed Payment Rule: Highlights for Anesthesia and Pain Management Providers

SummaryThe proposed Medicare Physician Fee Schedule for 2019 includes a slight increase in the anesthesia conversion factor as well as some changes to the Quality Payment Program and a significant overhaul of documentation requirements for Evaluation & Management services. CMS is accepting comments on the proposal until September 10, 2018. The ...
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What is the Right Compensation for Your Providers?

Jody Locke, MA Vice President of Anesthesia and Pain Practice Management Services Anesthesia Business Consultants, LLC, Jackson, MIMany anesthesia practices complain that their biggest challenge is to generate enough funds to cover the cost of a sufficient number of providers to meet the expectations and service requirements of the facilities they ...
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Adding Focus and Structure to Anesthesia Patient Handoffs

SummaryPatient handoffs are a significant source of errors in intraoperative and perioperative settings. Efforts to reduce these errors often succeed at first, but do not result in behavior change that lasts. A highly structured six-stage patient handoff implementation strategy developed at Midland Memorial Hospital in Texas has reduced handoff err...
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Lessons Learned: Five Tips for Buying or Selling a Practice

Kathryn Hickner, Esq. Kohrman, Jackson & Krantz LLP, Cleveland, OH If you are anticipating buying or selling a practice during the coming months, you are not alone. The healthcare industry is experiencing a wave of integration. In fact, it has been occurring for several years. Many transactional healthcare attorneys have negotiated and closed d...
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Blockchain Technology in Anesthesia: Disruptor or Fad?

SummaryThe use of blockchain technology in healthcare could help solve problems of interoperability, privacy, security, transparency and patient access to information, transforming the sector, according to proponents. We explore potential uses for this emerging technology in healthcare and medicine, including anesthesia.Among emerging technologies,...
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Expanding Into Non-Hospital Venues: The True Measures of Success

Jody Locke, MA Vice President of Anesthesia and Pain Practice Management Services Anesthesia Business Consultants, LLC, Jackson, MI The typical anesthesia practice now includes a combination of traditional hospital facilities and ambulatory surgery centers (ASCs), endoscopy centers and other outpatient venues such as doctors' offices. With the cont...
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Anesthesiologist Supply and Demand: Trends Within the Specialty

SummaryTwo new studies point to an increased demand for medical specialists, including anesthesiologists, in the coming years and decades. We review reports from the American Association of Medical Colleges and recruitment firm Merritt Hawkins, and offer thoughts on the implications of these findings for anesthesia groups and practitioners.Is there...
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Leading Leaders: Building Influence in a High-Talent Group

Will Latham, MBA President, Latham Consulting Group, Inc., Chattanooga, TNIn despair at the way its programs were organized, the business school at one university recruited as the director of programs a successful businessman, who had made a modest fortune in his own business and wanted to move on to a new career. "I will soon put some order in thi...
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Concurrency Defined: A Reminder for Anesthesia Providers

SummaryConcurrency is the number of cases an anesthesia provider is involved in at a given moment in time. It applies to all anesthesia cases performed by any type of provider and to all insurance companies. Because the accurate documentation of time is so important in this aspect of billing, we recommend using a single time piece to document anest...
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What Is the Value of Data and What Data Has Value? Today’s Anesthesia Management Challenge

What is it that makes today's anesthesia providers so good at managing patients safely through the trauma and discomfort of surgery? While many will cite the value of experience, the most critical factor is the availability of timely and relevant data that facilitates critical management decision making at appropriate junctures in the case.The curi...
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Legal Cases Underscore Compliance Lessons for Anesthesia and Pain Groups: Part 3

SummaryWe review takeaways from the Advanced Institute for Anesthesia Practice Management on recent legal cases of interest to anesthesia and pain practices pertaining to incorrect billing for anesthesia time and violations of the Anti-Kickback Statute. We continue this week with our third eAlert highlighting legal cases related to significant risk...
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