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'You can't do that!'

There are so many changes that affect coding and reimbursement, it's not difficult to understand that some of the changes are not well-received by dermatologists. This is especially true with many new services that include costly drugs and equipment and that require a significant amount of physician time to perform.In this issue, I'll share some questions sent in by frustrated readers, their solutions to the reimbursement dilemmas, and my "You can't do that" advice.

National report ? As in any profession, the practice of dermatology is subject to the vagaries of trends that can affect every practitioner.

Four key areas to look at when evaluating a billing service are: integration, performance, cost and relationship.

One of the biggest changes in the 2006 CPT book involves the grafting section of the Integumentary System. There were many deletions, a host of new codes and a significant number of amendments to the rules and guidelines that govern these complex surgical procedures.

Presently, VistA-Office EHR supports electronic reproductions of paper patient charts, from vital sign entry and viewing to problem list and medication management.

National report — Experts tell Dermatology Times that in addition to learning to do more with less, dermatologists face financial challenges unique to their specialty.

Year 2005 was filled with many changes that affected dermatologists and how they billed Medicare and other commercial carriers. Year 2006 is anticipated to be an equally challenging year. In this article, I will highlight what I feel was important this year and what you need to be aware of in the year ahead. Due to the space constraints of this article, I cannot go into great detail, but I will at least let you know what you should be aware of and what you need to implement.

Practice dashboard

The dashboard won't tell you why something is going wrong, but by identifying variances it will give early warning to potential problems.

Q I billed Medicare for the following services. All of the Mohs procedures were denied. Patient was in a 90-day postoperative period for a flap that was done 20 days earlier. Tell me how I should have coded to avoid the denials of my Mohs services?

San Francisco — Switching to electronic health records (EHRs) could prove costly and time-consuming for some small medical practices, according to a recent report.

Typically, you will be completely dependent on your high-speed Internet connection, and may not be able to function without that connection.

National report — Nowadays, there are so many different employee rights, it behooves employers to make sure they have a fundamental labor and employment law compliance plan in place.

National report — The driving force behind the growth in private insurance spending between 1987 and 2002 was the rise in treated disease prevalence, rather than the rise in spending per treated case, according to a new study from Emory University in Atlanta.

There is probably no single dermatology practice in this country that doesn't do biopsies, shave removals or excisions that require that a skin specimen be sent to an outside reference lab. A few practices have an in-house laboratory, but it still can be several days before the in-house dermatopathologist has time to read the slides.