StreamlineMD

! 1!!

! 2!

Contact Information

Address: 3333 S. Arlington Road, Akron, OH 44312 Sales (Toll Free): 866.406.2224

Sales (Local): 330.475.7049 Support (Toll Free): 866.460.0388

Support (Local): 330.475.7217 Fax: 330.706.6343

Email: [email protected]

!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

! 3!

Who is StreamlineMD™? StreamlineMD™ is a technology-enabled healthcare business service company. We offer a complete collection of services for physician office practices to help them streamline the management of their clinical and billing information. Our solutions, offered on a subscription-basis, include full-spectrum EHR, Practice Management and Billing Services. Our services also include the guidance, training, and support necessary for successful adoption of new technologies. In our subscription pricing model, all updates, upgrades, hosting, and support are included.

StreamlineMD, LLC is a wholly owned subsidiary of PRC Medical, LLC.

StreamlineMD's Mission Our mission is to be the leading provider of tools and services for streamlining medical practice operations, clinical documentation, billing and patient care. We offer the guidance and personalized support physicians need to adopt new technologies successfully and to keep pace with the challenges in the healthcare industry. StreamlineMD™ focuses on creating measurable results for each of our clients and helping them better enjoy the independent physician experience.

StreamlineMD's Commitments • High-quality services based on honesty, cooperation and hard work. • Delivering value to our clients and their patients. • Pursuit of excellence in all our endeavors. • Respect for our clients, partners, suppliers and employees—and an expectation of respect in

return. Improvement of our clients’ productivity—with minimal business disruption during the initial deployment—through our incremental implementation process.

January/2012 ~ Vein Views™ Newsletter Treatment Combinations for Varicose Veins: Important Documentation Tips Introduction:

As a general rule, when multiple procedures are performed during the same session, each has the potential to be reimbursed as long as medical necessity is met and the documentation is concise. Because medical necessity requirements can vary from one payer to the next, it is best to check with the patient's payer just prior to performing the procedure. The physician's supporting documentation (describing what was done and why) remains the same regardless of the payer. The purpose of this newsletter is to help avoid unfavorable audits and possibly avoid denials by providing tips on how to properly document cases when more than one vein treatment is performed.

Behind the Scenes: CPT (procedure) codes and ICD-9-CM (diagnosis) codes are assigned based only physician’s documentation.

• ICD-9-CM codes tell a payer why a certain procedure was performed. • CPT (procedure) codes tell a payer what you did and indicate how much to

pay. A coder may know that the physician performed a certain procedure, but without documentation, a code cannot be assigned.

! 4!

Documenting Two Treatments – No Shortcuts: One of the jobs an auditor has is to make sure there is supporting documentation for each CPT code assigned. Payers also may scrutinize a claim more carefully when two procedures are billed for the same encounter. For example, if a physician performs phlebectomy, EVLA, and foam sclerotherapy during the same patient encounter, the physician’s documentation must fully describe each procedure performed. Does it mean that each procedure has to be on a separate paragraph or even on a separate report? The answer is “no.” But what is important is that when more than one treatment is performed, be sure to document:

• Medical necessity for each treatment • A detailed description for each procedure For each treatment performed, document:

• The name/location of the vessel treated • If applicable, the diameter of the vessel treated • Details as to why the treatment was performed on that vessel • The laterality (left side, right side) • The type of treatment (e.g., laser, radiofrequency) • If applicable, the name and volume of the drug injected Limitations:

As previously stated, not all payers are alike. Some payers have detailed policies in place that identify certain limitations. For example:

• Following EVLA, if foam sclerotherapy is performed to treat reopened veins without recurrent signs or symptoms, a payer may not elect to pay for the foam sclerotherapy

• A payer may elect not to reimburse when laser ablation is performed of veins with a diameter greater than 20 mm

• Before treatment of symptomatic varicosities, some payers may require documentation of a failed 6 week trail of conservative therapy

In summary:

• Describe each treatment performed • Include the reason why each treatment was performed • Payers have medical necessity requirements along with limitations. Be aware of what they are

before treatments are performed. (Medicare Local Coverage Determination for Vein Treatments can be found at CMS LCD Vein Treatment) If you are a StreamlineMD client and need assistance navigating this website link, please call us at 330.564.2618.

! 5!

! 6!

Contact Information

Address: 3333 S. Arlington Road, Akron, OH 44312 Sales (Toll Free): 866.406.2224

Sales (Local): 330.475.7049 Support (Toll Free): 866.460.0388

Support (Local): 330.475.7217 Fax: 330.706.6343

Email: [email protected]

!