HIPAA AND X-RAYS<

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Q What is the HIPAA policy regarding the storage of X-rays?

A HIPAA does not make any specific requirements for X-rays. As with all medical materials, you need to provide reasonable safeguards to protect them.
You should have written guidelines stating who can access them and some protection in place to keep just anyone from looking at them. HIPAA treats X-rays no differently from medical records in general, so whatever you are doing for your records -- provided you are HIPAA-compliant there -- should suffice for the X-rays as well.

COMPLETE THE RECORD

Q If a physician checks or writes a diagnosis on a charge ticket but didn't note the diagnosis in the medical record, can the biller code the diagnosis that is on the charge ticket? Is the ticket a sufficient record for billing?

A According to Susan Callaway, CPC, an independent coding consultant and educator in North Augusta, S.C., the charge ticket is not sufficient documentation. It is not part of the medical record; the diagnosis must be in the record. The physician can make an addendum if needed.

M.A. BILLING

Q We have a patient who comes in every three days for our medical assistant to apply a pain patch. We often have to use a clinic-supplied shaver, and we hold and control his medication at the clinic. Can this patient's visits be billed as a 99211?

A According to Susan Callaway, CPC, you may bill a 99211 for this service.

TRACKING BP, MEDS

Q I am looking for a template for blood pressure tracking and a medication list that patients could bring to each appointment.

A To help you and your patients keep track of medications, use the Medication Chart at www.PhysiciansPractice.com. Click on Tools and scroll down to the For Patients section. We have also seen practices have great success asking patients simply to bring in every drug and over-the-counter remedy or vitamin they take in a brown bag and have the physician review them all.
There are some Web sites you can try for help with blood pressure tracking, including www.bloodpressure.com.

BILLING COMPANY CHARGES

Q Is there a chart available that will itemize the usual fees a service bureau charges?

A Fees are usually based on a percentage of actual collections. This percentage will vary according to the size and specialty of the practice.
The following are fee percentage ranges for various specialties, according to the Healthcare Billing and Management Association (previously the International Billing Association), a trade group of billing professionals:
* Radiology 8.5% to 13%
* Anesthesiology 5.3% to 6.5%
* Pathology 9.5% to 10.5%
* Surgery 3.5% to 7.5%
* Emergency Medicine 10% to 13%
* Primary Care 10% to 15%

For Healthcare Professionals