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For The Record Magazine - eNewsletter
November 2009
In this issue...


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Other News

Finding a Niche in EHRs
A San Antonio businessman is reaping the benefits of the EHR movement, according to the San Antonio Business Journal.

West Virginia Healthcare Gets High-Tech Boost
The Bluefield Daily Telegraph reports on a broadband project that will connect healthcare facilities in West Virginia’s greater Huntington region and rural McDowell County.

Medical Records: Stored in the Cloud, Sold on the Open Market
Medical records are seen as a commodity in this article from

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Editor’s E-Note

In this month’s E-News Exclusive, we pose five questions to John Klimek, RPh, senior vice president of industry IT for the National Council for Prescription Drug Programs (the pharmacy standards development organization that has been named in various government legislation, including HIPAA) and a member of the HIT Standards Committee. Klimek believes the HITECH Act poses a huge challenge for those in charge of making sure their facility is HIPAA compliant.

— Lee DeOrio, editor
E-News Exclusive

For The Record Q & A With John Klimek, RPh

FTR: What are the effects of the new HIPAA laws contained in the HITECH Act?

Klimek: HITECH makes significant changes to HIPAA by defining “business associate” more broadly, making business associates directly accountable under the statute, augmenting enforcement provisions, and increasing limitations on the use of personal health information (PHI). HITECH also imposes new disclosure accounting obligations for electronic health records and new breach notification requirements for unauthorized disclosures.


Recently in For The Record...

Solarity IndexingThe PHR: Moving Consumers From Pawns to Kings
The authors of a new book state their case as to why this technology needs to play a more prominent role in the dissemination of healthcare information. Read more

Crush Medication Errors
Installing bar-coding technology raises patient satisfaction, decreases the chance of mistakes, and changes workflow throughout many departments. Read more

CAC: It Still Needs the Human Touch
Healthcare facilities are taking a huge risk if they rely solely on computer-assisted coding technology to satisfy their billing needs. Read more

Get Buy-In Before Buying
With the federal government in a generous mood, it seems like the perfect time to adopt new mobile technology. However, experts caution that hospitals would be wise to check with their physicians first. Read more

Industry Insight

Preventing Medical Errors: Avoid Blame Game but Punish Habitual Offenders

Patient safety experts at Johns Hopkins and elsewhere are taking their prescription for avoiding medical errors in hospital care one step beyond already successful “no-fault, no-blame” approaches, now calling for penalties for doctors and nurses who fail to comply with proven safety measures. Penalties should only apply, these experts say, when current no-blame practices designed to prevent recurrences stall and, after warnings and counseling, have failed to change healthcare workers’ behavior.

“Our preference during the last decade for not assigning blame to individuals went a long way to encourage the disclosure of medical errors and getting buy-in for the idea that systemic safety problems existed and could be fixed,” says anesthesiologist Peter Pronovost, MD, PhD, a patient safety expert at Johns Hopkins.

“But despite making systems safer and counseling staff on best practices, mistakes continue to happen, so it’s time to add some accountability and enforcement policies to address and stop unsafe practices,” he says.


Ask the Expert

Have a coding or transcription question?
Get an expert answer by sending an e-mail to

When coding replacement of pacemaker generator, the notes say two codes are needed: one for the removal and one for the replacement. I have two coding cases for replacement of pacemaker generator. They both say 33213 only is the correct code. I don’t understand why a second code is not needed since the notes in the coding manual state two codes are needed.

Lela Delaney
Northwest Mississippi Community College


One code is needed for the removal of the pulse generator and another code is needed for the insertion of the new generator. As per the American Medical Association, the word “replacement” in the CPT descriptor (33212) is not meant to imply that the removal of the existing device is included in the aforementioned code (addressed by the American Medical Association in 1994 and 2004 via CPT Assistants).

Anthony McCallum, CPC, CIRCC, CPC-I, CCS
American Academy of Professional Coders Medical Coding & Billing Forum

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