Q Does having a C-arm in our new orthopedic surgery center mean we must adhere to special state or Medicare requirements?

A Medicare requires you to have a contract with a Medicare-certified radiology center. However, it doesn't require that the contract be with a hospital radiology department. State requirements vary, so check with your state for specific rules and regulations. Note that if you don't employ a contracted radiology technician in your OR, the operating surgeon must be the one to adjust and operate the C-arm. By law, nurses and other OR personnel aren't allowed to perform these tasks.

Q We aren't able to have an information technology staff, so how do we protect our data from all the worms and viruses out there?

A Even if you're not a computer guru, you can take these basic steps to protect your computers from invasion.

• Completely back up your data daily. This will not prevent a virus or worm's intrusion, but if your system is infected, you'll have recent data to reinstall after your system is fixed.
• Buy reliable anti-virus software capable of scanning drives (the contents of your computer, disks and CDs), incoming and outgoing e-mail and Internet downloads. The cost is minimal, installation easy and set-up is uncomplicated. Just installing the anti-virus software is not enough. At the very least, you need to perform weekly updates of the virus software.
• Never open e-mail attachments from unexpected or unrecognized sources, introduce to your system disks or CDs whose integrity you cannot verify, or download files or programs from unknown Internet sites (including screen savers, decorative desktop icons or password-saving programs).

Remember, individuals, not virus-protecting software, most control preventing infection. Following these suggestions will virtually eliminate a virus or worm's ability to damage your data or allow access to confidential information.

Q Where can I get a list of approved prosthetic-device codes?

A Check with your local Medicare carrier for such a list, but very few Medicare-approved prosthetic-device codes are allowable in an ASC. Most reimbursement success comes from the carve-out of implants/prosthetic devices in the insurance contracts. While you're negotiating, determine if the unspecified HCPCS supply code will be used or the generic 99070, as well as what revenue code will be used. Implants in excess of $100 are usually carved out to recoup cost, plus at least 10 to 20 percent for shipping and handling.

Q Is CPT 99070 valid for the ASC setting? We haven't used 99070 for screws and plates because the description includes "provided by the physician."

A While the use of 99070 is carrier-specific, for many it's an acceptable way to bill for reimbursement of miscellaneous supplies. Your contract language should specify this, along with the revenue code the carrier requires.