emblemhealth lost 500 million 2014
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Emblemhealth lost 500 million 2014 james fawcett highmark

Emblemhealth lost 500 million 2014

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Insertion or replacement of permanent subcutaneous implantable defibrillator system, with subcutaneous electrode, including defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters, when performed. Percutaneous transcatheter closure of the left atrial appendage with endocardial implant, including fluoroscopy, transseptal puncture, catheter placement s , left atrial angiography, left atrial appendage angiography, when performed, and radiological supervision and interpretation.

Replacement, aortic valve, open, with cardiopulmonary bypass; with prosthetic valve other than homograft or stentless valve. Replacement, aortic valve; by translocation of autologous pulmonary valve with allograft replacement of pulmonary valve Ross procedure. Ventriculomyotomy -myectomy for idiopathic hypertrophic subaortic stenosis e. Valvuloplasty, mitral valve, with cardiopulmonary bypass; radical reconstruction, with or without ring. Transcatheter pulmonary valve implantation, percutaneous approach, including pre-stenting of the valve delivery site, when performed.

Repair of anomalous coronary artery from pulmonary artery origin; by graft, with cardiopulmonary bypass. Repair of anomalous e. Reoperation, coronary artery bypass procedure or valve procedure, more than 1 month after original operation List separately in addition to code for primary procedure.

Surgical ventricular restoration procedure, includes prosthetic patch, when performed e. Closure of multiple ventricular septal defects; with pulmonary valvotomy or infundibular resection acyanotic. Closure of multiple ventricular septal defects; with removal of pulmonary artery band, with or without gusset. Closure of single ventricular septal defect, with or without patch; with pulmonary valvotomy or infundibular resection acyanotic. Closure of single ventricular septal defect, with or without patch; with removal of pulmonary artery band, with or without gusset.

Ascending aorta graft, with cardiopulmonary bypass, with aortic root replacement using valved conduit and coronary reconstruction e. Ascending aorta graft, with cardiopulmonary bypass with valve suspension, with coronary reconstruction and valve-sparing aortic root remodeling e.

Endovascular repair of descending thoracic aorta e. Placement of proximal extension prosthesis for endovascular repair of descending thoracic aorta e.

Placement of distal extension prosthesis s delayed after endovascular repair of descending thoracic aorta. Removal of a total replacement heart system artificial heart for heart transplantation List separately in addition to code for primary procedure.

Backbench standard preparation of cadaver donor heart allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare aorta, superior vena cava, inferior vena cava, pulmonary artery, and left atrium for implantation.

Replacement of extracorporeal ventricular assist device, single or biventricular, pump s , single or each pump. Replacement of ventricular assist device pump s ; implantable intracorporeal, single ventricle, without cardiopulmonary bypass. Replacement of ventricular assist device pump s ; implantable intracorporeal, single ventricle, with cardiopulmonary bypass.

Embolectomy or thrombectomy, with or without catheter; axillary, brachial, innominate, subclavian artery, by arm incision. Embolectomy or thrombectomy, with or without catheter; renal, celiac, mesentery, aortoiliac artery, by abdominal incision. Embolectomy or thrombectomy, with or without catheter; femoropopliteal, aortoiliac artery, by leg incision.

Embolectomy or thrombectomy, with or without catheter; popliteal-tibio-peroneal artery, by leg incision. Open femoral artery exposure for delivery of endovascular prosthesis, by groin incision, unilateral. Open iliac artery exposure for delivery of endovascular prosthesis or iliac occlusion during endovascular therapy, by abdominal or retroperitoneal incision, unilateral. Direct repair of aneurysm, pseudoaneurysm, or excision partial or total and graft insertion, with or without patch graft; for aneurysm and associated occlusive disease, axillary-brachial artery, by arm incision.

Direct repair of aneurysm, pseudoaneurysm, or excision partial or total and graft insertion, with or without patch graft; for ruptured aneurysm, axillary-brachial artery, by arm incision. Direct repair of aneurysm, pseudoaneurysm, or excision partial or total and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, radial or ulnar artery.

Direct repair of aneurysm, pseudoaneurysm, or excision partial or total and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, hepatic, celiac, renal, or mesenteric artery. Direct repair of aneurysm, pseudoaneurysm, or excision partial or total and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, common femoral artery profunda femoris, superficial femoral.

Direct repair of aneurysm, pseudoaneurysm, or excision partial or total and graft insertion, with or without patch graft; for ruptured aneurysm, common femoral artery profunda femoris, superficial femoral. Direct repair of aneurysm, pseudoaneurysm, or excision partial or total and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, popliteal artery.

Direct repair of aneurysm, pseudoaneurysm, or excision partial or total and graft insertion, with or without patch graft; for ruptured aneurysm, popliteal artery. Thromboendarterectomy, including patch graft, if performed; carotid, vertebral, subclavian, by neck incision.

Bypass graft, with vein; femoral-anterior tibial, posterior tibial, peroneal artery or other distal vessels. Bypass graft, with other than vein; femoral-anterior tibial, posterior tibial, or peroneal artery. Revision, lower extremity arterial bypass, without thrombectomy, open; with vein patch angioplasty. Revision, lower extremity arterial bypass, without thrombectomy, open; with segmental vein interposition.

Revision, femoral anastomosis of synthetic arterial bypass graft in groin, open; with nonautogenous patch graft e. Revision, femoral anastomosis of synthetic arterial bypass graft in groin, open; with autogenous vein patch graft. Selective catheter placement, arterial system; initial third order or more selective abdominal, pelvic, or lower extremity artery branch, within a vascular family. Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; single incompetent extremity truncal vein e.

Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; multiple incompetent truncal veins e. Single or multiple injections of sclerosing solutions, spider veins telangiectasia ; limb or trunk.

Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated.

Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; first vein treated. Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive e. Transcatheter placement of intravascular stent s , central dialysis segment, performed through dialysis circuit, including all imaging radiological supervision and interpretation required to perform the stenting, and all angioplasty in the central dialysis segment List separately in addition to code for primary procedure.

Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection s ; initial vessel.

Transcatheter placement of intravascular stent s , cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; with distal embolic protection. Transcatheter placement of intravascular stent s , cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; without distal embolic protection.

Transcatheter placement of intravascular stent s , intrathoracic common carotid artery or innominate artery by retrograde treatment, open ipsilateral cervical carotid artery exposure, including angioplasty, when performed, and radiological supervision and interpretation. Transcatheter placement of intravascular stent s , intrathoracic common carotid artery or innominate artery, open or percutaneous antegrade approach, including angioplasty, when performed, and radiological supervision and interpretation.

Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal angioplasty. Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal stent placement s , includes angioplasty within the same vessel, when performed. Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal angioplasty List separately in addition to code for primary procedure.

Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal stent placement s , includes angioplasty within the same vessel, when performed List separately in addition to code for primary procedure.

Revascularization, endovascular, open or percutaneous, femoral, popliteal artery s , unilateral; with transluminal angioplasty. Revascularization, endovascular, open or percutaneous, femoral, popliteal artery s , unilateral; with atherectomy, includes angioplasty within the same vessel, when performed.

Revascularization, endovascular, open or percutaneous, femoral, popliteal artery s , unilateral; with transluminal stent placement s , includes angioplasty within the same vessel, when performed. Revascularization, endovascular, open or percutaneous, femoral, popliteal artery s , unilateral; with transluminal stent placement s and atherectomy, includes angioplasty within the same vessel, when performed.

Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with atherectomy, includes angioplasty within the same vessel, when performed. Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal stent placement s , includes angioplasty within the same vessel, when performed.

Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal stent placement s and atherectomy, includes angioplasty within the same vessel, when performed.

Transcatheter placement of an intravascular stent s except lower extremity artery s for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary , open or percutaneous, including radiological supervision and interpretation and including all angioplasty within the same vessel, when performed; initial artery.

Transcatheter placement of an intravascular stent s except lower extremity artery s for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary , open or percutaneous, including radiological supervision and interpretation and including all angioplasty within the same vessel, when performed; each additional artery List separately in addition to code for primary procedure.

Transcatheter placement of an intravascular stent s , open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; initial vein. Transcatheter placement of an intravascular stent s , open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; each additional vein.

Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; venous, other than hemorrhage e. Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; arterial, other than hemorrhage or tumor e.

Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for tumors, organ ischemia, or infarction. Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for arterial or venous hemorrhage or lymphatic extravasation.

Transluminal balloon angioplasty except lower extremity artery ies for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit , open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same artery; initial artery.

Transluminal balloon angioplasty except lower extremity artery ies for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit , open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same artery; each additional artery List separately in addition to code for primary procedure. Transluminal balloon angioplasty except dialysis circuit , open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; initial vein.

Transluminal balloon angioplasty except dialysis circuit , open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; each additional vein List separately in addition to code for primary procedure. Ligation and division of long saphenous vein at saphenofemoral junction, or distal interruptions. Ligation, division, and stripping, long greater saphenous veins from saphenofemoral junction to knee or below.

Ligation of perforator veins, subfascial, radical Linton type , including skin graft, when performed, open,1 leg. Ligation of perforator vein s , subfascial, open, including ultrasound guidance, when performed, 1 leg. Unlisted procedure, vascular surgery Stab phlebectomy of varicose veins, one extremity; less than 10 stab incisions.

Splenectomy; total, en bloc for extensive disease, in conjunction with other procedure List in addition to code for primary procedure. Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; allogeneic. Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous. Transplant preparation of hematopoietic progenitor cells; thawing of previously frozen harvest, without washing, per donor.

Transplant preparation of hematopoietic progenitor cells; thawing of previously frozen harvest, with washing, per donor. Transplant preparation of hematopoietic progenitor cells; specific cell depletion within harvest, T-cell depletion.

Transplant preparation of hematopoietic progenitor cells; cell concentration in plasma, mononuclear, or buffy coat layer. Biopsy or excision of lymph node s ; by needle, superficial e. Excision of parotid tumor or parotid gland; lateral lobe, with dissection and preservation of facial nerve. Excision of parotid tumor or parotid gland; total, with dissection and preservation of facial nerve. Excision of parotid tumor or parotid gland; total, en bloc removal with sacrifice of facial nerve.

Total or near total esophagectomy, without thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty transhiatal. Total or near total esophagectomy, without thoracotomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation and anastomosis es. Total or near total esophagectomy, with thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty.

Total or near total esophagectomy, with thoracotomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis es. Partial esophagectomy, cervical, with free intestinal graft, including microvascular anastomosis, obtaining the graft and intestinal reconstruction.

Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with thoracic esophagogastrostomy, with or without pyloroplasty Ivor Lewis. Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis es.

Partial esophagectomy, distal two-thirds, with thoracotomy only, with or without proximal gastrectomy, with thoracic esophagogastrostomy, with or without pyloroplasty.

Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with esophagogastrostomy, with or without pyloroplasty. Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis es. Total or partial esophagectomy, without reconstruction any approach , with cervical esophagostomy.

Esophagoscopy, rigid or flexible, transoral; with directed submucosal injection s , any substance. Esophagoscopy, flexible, transoral; with dilation of esophagus with balloon 30 mm diameter or larger includes fluoroscopic guidance, when performed. Esophagoscopy, flexible, transoral; with ablation of tumor s , polyp s , or other lesion s includes pre- and post-dilation and guide wire passage, when performed.

Esophagogastroduodenoscopy, flexible, transoral; with dilation of esophagus with balloon 30 mm diameter or larger includes fluoroscopic guidance, when performed. Esophagogastroduodenoscopy, flexible, transoral; with directed submucosal injection s , any substance.

Esophagogastroduodenoscopy, flexible, transoral; with directed placement of percutaneous gastrostomy tube. Esophagogastroduodenoscopy, flexible, transoral; with ablation of tumor s , polyp s , or other lesion s includes pre- and post-dilation and guide wire passage, when performed. Laparoscopy, surgical, esophageal sphincter augmentation procedure, placement of sphincter augmentation device ie, magnetic band , including cruroplasty when performed.

Esophagoplasty plastic repair or reconstruction , cervical approach; without repair of tracheoesophageal fistula. Esophagoplasty plastic repair or reconstruction , cervical approach; with repair of tracheoesophageal fistula. Esophagoplasty plastic repair or reconstruction , thoracic approach; without repair of tracheoesophageal fistula.

Repair, paraesophageal hiatal hernia including fundoplication , via laparotomy, except neonatal; without implantation of mesh or other prosthesis. Repair, paraesophageal hiatal hernia including fundoplication , via laparotomy, except neonatal; with implantation of mesh or other prosthesis.

Repair, paraesophageal hiatal hernia including fundoplication , via thoracotomy, except neonatal; without implantation of mesh or other prosthesis. Repair, paraesophageal hiatal hernia including fundoplication , via thoracotomy, except neonatal; with implantation of mesh or other prosthesis. Repair, paraesophageal hiatal hernia, including fundoplication , via thoracoabdominal incision, except neonatal; with implantation of mesh or other prosthesis.

Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux-en-Y gastroenterostomy roux limb cm or less. Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and small intestine reconstruction to limit absorption. Laparoscopy, surgical; implantation or replacement of gastric neurostimulator electrodes, antrum.

Laparoscopy, surgical, gastric restrictive procedure; placement of adjustable gastric restrictive device e. Laparoscopy, surgical, gastric restrictive procedure; revision of adjustable gastric restrictive device component only.

Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device component only. Laparoscopy, surgical, gastric restrictive procedure; removal and replacement of adjustable gastric restrictive device component only. Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components.

Gastric restrictive procedure, without gastric bypass, for morbid obesity; vertical-banded gastroplasty. Gastric restrictive procedure, without gastric bypass, for morbid obesity; other than vertical-banded gastroplasty. Gastric restrictive procedure with partial gastrectomy, pylorus-preserving duodenoileostomy and ileoileostomy 50 to cm common channel to limit absorption biliopancreatic diversion with duodenal switch.

Gastric restrictive procedure, with gastric bypass for morbid obesity; with short limb cm or less Roux-en-Y gastroenterostomy. Gastric restrictive procedure, with gastric bypass for morbid obesity; with small intestine reconstruction to limit absorption.

Revision, open, of gastric restrictive procedure for morbid obesity, other than adjustable gastric restrictive device separate procedure. Gastric restrictive procedure, open; removal and replacement of subcutaneous port component only. Enterotomy, small intestine, other than duodenum; for exploration, biopsy s , or foreign body removal. Enterectomy, resection of small intestine; each additional resection and anastomosis List separately in addition to code for primary procedure.

Enteroenterostomy, anastomosis of intestine, with or without cutaneous enterostomy separate procedure. Laparoscopy, surgical; colectomy, partial, with end colostomy and closure of distal segment Hartmann type procedure. Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy low pelvic anastomosis.

Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy low pelvic anastomosis with colostomy. Laparoscopy, surgical, closure of enterostomy, large or small intestine, with resection and anastomosis.

Placement, enterostomy or cecostomy, tube open e. Colostomy or skin level cecostomy; with multiple biopsies e. Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with placement of percutaneous jejunostomy tube. Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with conversion of percutaneous gastrostomy tube to percutaneous jejunostomy tube.

Anoscopy; diagnostic, with high-resolution magnification HRA e. Anoscopy; with high-resolution magnification HRA e. Donor hepatectomy including cold preservation , from living donor; left lateral segment only segments II and III. Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepare the vena cava, portal vein, hepatic artery, and common bile duct for implantation; without trisegment or lobe split.

Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepare the vena cava, portal vein, hepatic artery, and common bile duct for implantation; with trisegment split of whole liver graft into 2 partial liver grafts ie, left lateral segment [segments II and III] and right trisegment [segments I and IV through VIII].

Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepare the vena cava, portal vein, hepatic artery, and common bile duct for implantation; with lobe split of whole liver graft into 2 partial liver grafts ie, left lobe [segments II, III, and IV] and right lobe [segments I and V through VIII].

Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; venous anastomosis, each. Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; arterial anastomosis, each. Biliary endoscopy, intraoperative choledochoscopy List separately in addition to code for primary procedure. Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy Whipple-type procedure ; with pancreatojejunostomy.

Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy Whipple-type procedure ; without pancreatojejunostomy. Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy pylorus-sparing, Whipple-type procedure ; with pancreatojejunostomy.

Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy pylorus-sparing, Whipple-type procedure ; without pancreatojejunostomy. Pancreatectomy, total or subtotal, with autologous transplantation of pancreas or pancreatic islet cells. Donor pancreatectomy including cold preservation , with or without duodenal segment for transplantation. Backbench standard preparation of cadaver donor pancreas allograft prior to transplantation, including dissection of allograft from surrounding soft tissues, splenectomy, duodenotomy, ligation of bile duct, ligation of mesenteric vessels, and Y-graft arterial anastomoses from iliac artery to superior mesenteric artery and to splenic artery.

Backbench reconstruction of cadaver donor pancreas allograft prior to transplantation, venous anastomosis, each. Conversion of gastrostomy tube to gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection s , image documentation and report. Pyelotomy; with removal of calculus pyelolithotomy, pelviolithotomy, including coagulum pyelolithotomy. Ablation, open, one or more renal mass lesion s , cryosurgical, including intraoperative ultrasound guidance and monitoring, if performed.

Backbench standard preparation of cadaver donor renal allograft prior to transplantation, including dissection and removal of perinephric fat, diaphragmatic and retroperitoneal attachments, excision of adrenal gland, and preparation of ureter s , renal vein s , and renal artery s , ligating branches, as necessary.

Backbench standard preparation of living donor renal allograft open or laparoscopic prior to transplantation, including dissection and removal of perinephric fat and preparation of ureter s , renal vein s , and renal artery s , ligating branches, as necessary. Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; venous anastomosis, each.

Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; arterial anastomosis, each. Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; ureteral anastomosis, each. Laparoscopy, surgical; ablation of renal mass lesion s , including intraoperative ultrasound guidance and monitoring when performed. Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes.

Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis. Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes.

Anterior vesicourethropexy, or urethropexy e. Abdomino-vaginal vesical neck suspension, with or without endoscopic control e. Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant. Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; each additional permanent adjustable transprostatic implant List separately in addition to code for primary procedure.

Urethroplasty, transpubic or perineal, 1-stage, for reconstruction or repair of prostatic or membranous urethra. Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; second stage. Transurethral radiofrequency micro-remodeling of the female bladder neck and proximal urethra for stress urinary incontinence. Urethroplasty for second stage hypospadias repair including urinary diversion ; greater than 3 cm. Urethroplasty for second stage hypospadias repair including urinary diversion with free skin graft obtained from site other than genitalia.

Urethroplasty for third stage hypospadias repair to release penis from scrotum e. Repair of hypospadias complications ie, fistula, stricture, diverticula ; requiring mobilization of skin flaps and urethroplasty with flap or patch graft. Repair of hypospadias cripple requiring extensive dissection and excision of previously constructed structures including re-release of chordee and reconstruction of urethra and penis by use of local skin as grafts and island flaps and skin brought in as flaps or grafts.

Plastic operation on penis for epispadias distal to external sphincter; with exstrophy of bladder. Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir. Removal of all components of a multi-component, inflatable penile prosthesis without replacement of prosthesis. Removal and replacement of all component s of a multi-component, inflatable penile prosthesis at the same operative session.

Removal and replacement of all components of a multi-component inflatable penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue. Removal of non-inflatable semi-rigid or inflatable self-contained penile prosthesis, without replacement of prosthesis. Removal and replacement of non-inflatable semi-rigid or inflatable self-contained penile prosthesis at the same operative session.

Removal and replacement of non-inflatable semi-rigid or inflatable self-contained penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue.

Orchiectomy, simple including subcapsular , with or without testicular prosthesis, scrotal or inguinal approach. Vasotomy, cannulization with or without incision of vas, unilateral or bilateral separate procedure. Exposure of prostate, any approach, for insertion of radioactive substance; with lymph node biopsy s limited pelvic lymphadenectomy. Exposure of prostate, any approach, for insertion of radioactive substance; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes.

Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy. Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue radical vaginectomy. Vaginectomy, complete removal of vaginal wall; with removal of paravaginal tissue radical vaginectomy.

Endometrial sampling biopsy with or without endocervical sampling biopsy , without cervical dilation, any method separate procedure. Total abdominal hysterectomy corpus and cervix , with or without removal of tube s , with or without removal of ovary s ;. Total abdominal hysterectomy corpus and cervix , with or without removal of tube s , with or without removal of ovary s ; with colpo-urethrocystopexy e.

Supracervical abdominal hysterectomy subtotal hysterectomy , with or without removal of tube s , with or without removal of ovary s. Total abdominal hysterectomy, including partial vaginectomy, with para-aortic and pelvic lymph node sampling, with or without removal of tube s , with or without removal of ovary s.

Radical abdominal hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling biopsy , with or without removal of tube s , with or without removal of ovary s. Vaginal hysterectomy, for uterus g or less; with colpo-urethrocystopexy Marshall-Marchetti-Krantz type, Pereyra type with or without endoscopic control. Catheterization and introduction of saline or contrast material for saline infusion sonohysterography SIS or hysterosalpingography.

Hysteroscopy, surgical; with endometrial ablation e. Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants. Laparoscopy, surgical; with lysis of adhesions salpingolysis, ovariolysis separate procedure. Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method. Laparotomy, for staging or restaging of ovarian, tubal, or primary peritoneal malignancy second look , with or without omentectomy, peritoneal washing, biopsy of abdominal and pelvic peritoneum, diaphragmatic assessment with pelvic and limited para-aortic lymphadenectomy.

Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal separate procedure ;.

Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal.

Cisternal or lateral cervical C1-C2 puncture; with injection of medication or other substance for diagnosis or treatment. Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, without electrocorticography during surgery. Hypophysectomy or excision of pituitary tumor, transnasal or transseptal approach, nonstereotactic. Transcatheter permanent occlusion or embolization e. Transcatheter placement of intravascular stent s , intracranial e. Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in different vascular family List separately in addition to code for primary procedure.

Surgery of intracranial aneurysm, cervical approach by application of occluding clamp to cervical carotid artery Selverstone-Crutchfield type. Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial and cervical occlusion of carotid artery.

Creation of lesion by stereotactic method, including burr hole s and localizing and recording techniques, single or multiple stages; globus pallidus or thalamus. Creation of lesion by stereotactic method, including burr hole s and localizing and recording techniques, single or multiple stages; subcortical structure s other than globus pallidus or thalamus.

Stereotactic implantation of depth electrodes into the cerebrum for long-term seizure monitoring. Stereotactic radiosurgery particle beam, gamma ray, or linear accelerator ; 1 simple cranial lesion. Stereotactic radiosurgery particle beam, gamma ray, or linear accelerator ; each additional cranial lesion, simple List separately in addition to code for primary procedure.

Stereotactic radiosurgery particle beam, gamma ray, or linear accelerator ; 1 complex cranial lesion. Stereotactic radiosurgery particle beam, gamma ray, or linear accelerator ; each additional cranial lesion, complex List separately in addition to code for primary procedure. Application of stereotactic headframe for stereotactic radiosurgery List separately in addition to code for primary procedure.

Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site e. Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array.

Percutaneous lysis of epidural adhesions using solution injection e. Injection s , of diagnostic or therapeutic substance s e. Injection s , including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance s e. Implantation or replacement of device for intrathecal or epidural drug infusion; subcutaneous reservoir. Implantation or replacement of device for intrathecal or epidural drug infusion; non programmable pump.

Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming. Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion. Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion includes evaluation of reservoir status, alarm status, drug prescription status ; without reprogramming.

Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion includes evaluation of reservoir status, alarm status, drug prescription status ; with reprogramming. Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion includes evaluation of reservoir status, alarm status, drug prescription status ; with reprogramming and refill. Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion includes evaluation of reservoir status, alarm status, drug prescription status ; with reprogramming and refill requiring skill of a physician or other qualified health care professional.

Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; with reconstruction of the posterior bony elements including the application of bridging bone graft and non-segmental fixation devices [eg, wire, suture, mini-plates], when performed. Costovertebral approach with decompression of spinal cord or nerve root s e. Vertebral corpectomy vertebral body resection , partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root s , lower thoracic or lumbar; single segment.

Vertebral corpectomy vertebral body resection , partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root s , lower thoracic or lumbar; each additional segment List separately in addition to code for primary procedure. Vertebral corpectomy vertebral body resection , partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root s , lower thoracic, lumbar, or sacral; single segment.

Vertebral corpectomy vertebral body resection , partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root s , lower thoracic, lumbar, or sacral; each additional segment List separately in addition to code for primary procedure.

Laminectomy and section of dentate ligaments, with or without dural graft, cervical; 1 or 2 segments. Laminectomy and section of dentate ligaments, with or without dural graft, cervical; more than 2 segments. Laminectomy with cordotomy with section of both spinothalamic tracts, 2 stages within 14 days; cervical. Laminectomy with cordotomy with section of both spinothalamic tracts, 2 stages within 14 days; thoracic.

Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracolumbar. Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; cervical. Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; thoracic. Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar.

Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; sacral. Osteoplastic reconstruction of dorsal spinal elements, following primary intraspinal procedure List separately in addition to code for primary procedure.

Vertebral corpectomy vertebral body resection , partial or complete, for excision of intraspinal lesion, single segment; extradural, cervical. Vertebral corpectomy vertebral body resection , partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by transthoracic approach. Vertebral corpectomy vertebral body resection , partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by thoracolumbar approach.

Vertebral corpectomy vertebral body resection , partial or complete, for excision of intraspinal lesion, single segment; extradural, lumbar or sacral by transperitoneal or retroperitoneal approach.

Vertebral corpectomy vertebral body resection , partial or complete, for excision of intraspinal lesion, single segment; intradural, cervical.

Vertebral corpectomy vertebral body resection , partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by transthoracic approach. Vertebral corpectomy vertebral body resection , partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by thoracolumbar approach.

Vertebral corpectomy vertebral body resection , partial or complete, for excision of intraspinal lesion, single segment; intradural, lumbar or sacral by transperitoneal or retroperitoneal approach. Vertebral corpectomy vertebral body resection , partial or complete, for excision of intraspinal lesion, single segment; each additional segment List separately in addition to codes for single segment. Stereotactic radiosurgery particle beam, gamma ray, or linear accelerator ; each additional spinal lesion List separately in addition to code for primary procedure.

Removal of spinal neurostimulator electrode percutaneous array s , including fluoroscopy, when performed. Revision including replacement, when performed, of spinal neurostimulator electrode percutaneous array s , including fluoroscopy, when performed.

Incision and subcutaneous placement of spinal neurostimulator pulse generator or receiver, direct or inductive coupling. Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; percutaneous, not requiring laminectomy. Injection, anesthetic agent; brachial plexus, continuous infusion by catheter including catheter placement. Injection, anesthetic agent; sciatic nerve, continuous infusion by catheter including catheter placement.

Injection, anesthetic agent; femoral nerve, continuous infusion by catheter including catheter placement. Injection, anesthetic agent; lumbar plexus, posterior approach, continuous infusion by catheter including catheter placement. Injection s , diagnostic or therapeutic agent, paravertebral facet zygapophyseal joint or nerves innervating that joint with image guidance fluoroscopy or CT , cervical or thoracic; single level.

Injection s , diagnostic or therapeutic agent, paravertebral facet zygapophyseal joint or nerves innervating that joint with image guidance fluoroscopy or ct , cervical or thoracic; second level list separately in addition to code for primary procedure. Injection s , diagnostic or therapeutic agent, paravertebral facet zygapophyseal joint or nerves innervating that joint with image guidance fluoroscopy or ct , cervical or thoracic; third and any additional level s list separately in addition to code for primary procedure.

Injection s , diagnostic or therapeutic agent, paravertebral facet zygapophyseal joint or nerves innervating that joint with image guidance fluoroscopy or CT , lumbar or sacral; single level. Injection s , diagnostic or therapeutic agent, paravertebral facet zygapophyseal joint or nerves innervating that joint with image guidance fluoroscopy or ct , lumbar or sacral; second level list separately in addition to code for primary procedure.

Injection s , diagnostic or therapeutic agent, paravertebral facet zygapophyseal joint or nerves innervating that joint with image guidance fluoroscopy or ct , lumbar or sacral; third and any additional level s list separately in addition to code for primary procedure. Percutaneous implantation of neurostimulator electrode array; sacral nerve transforaminal placement including image guidance, if performed. Posterior tibial neurostimulation, percutaneous needle electrode, single treatment, includes programming.

Incision for implantation of cranial nerve e. Revision or replacement of cranial nerve e. Removal of cranial nerve e.

Incision for implantation of neurostimulator electrode array; peripheral nerve excludes sacral nerve. Incision for implantation of neurostimulator electrodes; sacral nerve transforaminal placement.

Insertion or replacement of peripheral or gastric neurostimulator pulse generator or receiver, direct or inductive coupling. Destruction by neurolytic agent, trigeminal nerve; supraorbital, infraorbital, mental, or inferior alveolar branch. Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale.

Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale under radiologic monitoring.

Chemodenervation of muscle s ; muscle s innervated by facial nerve e. Chemodenervation of muscle s ; muscle s innervated by facial, trigeminal, cervical spinal and accessory nerves, bilateral e.

Chemodenervation of muscle s ; neck muscle s , excluding muscles of the larynx, unilateral e. Chemodenervation of muscle s ; larynx, unilateral, percutaneous e. Destruction by neurolytic agent, paravertebral facet joint nerve s , with imaging guidance fluoroscopy or CT ; cervical or thoracic, single facet joint.

Destruction by neurolytic agent, paravertebral facet joint nerve s , with imaging guidance fluoroscopy or CT ; cervical or thoracic, each additional facet joint List separately in addition to code for primary procedure.

Destruction by neurolytic agent, paravertebral facet joint nerve s , with imaging guidance fluoroscopy or CT ; lumbar or sacral, single facet joint. Destruction by neurolytic agent, paravertebral facet joint nerve s , with imaging guidance fluoroscopy or CT ; lumbar or sacral, each additional facet joint List separately in addition to code for primary procedure. Chemodenervation of one extremity; each additional extremity, muscle s list separately in addition to code for primary procedure.

Chemodenervation of one extremity; each additional extremity, 5 or more muscles list separately in addition to code for primary procedure. Nerve repair; with nerve allograft, , each additional strand List separately in addition to code for primary procedure. Backbench preparation of corneal endothelial allograft prior to transplantation List separately in addition to code for primary procedure.

Severing adhesions of anterior segment of eye, incisional technique with or without injection of air or liquid separate procedure ; anterior synechiae, except goniosynechiae. Fistulization of sclera for glaucoma; trabeculectomy ab externo with scarring from previous ocular surgery or trauma includes injection of antifibrotic agents.

Insertion of anterior segment aqueous drainage device, without extraocular reservoir, external approach. Implantation of intravitreal drug delivery system e. Destruction of localized lesion of choroid e. Strabismus surgery, recession or resection procedure; 1 vertical muscle excluding superior oblique. Strabismus surgery, recession or resection procedure; 2 or more vertical muscles excluding superior oblique.

Transposition procedure e. Strabismus surgery on patient with previous eye surgery or injury that did not involve the extraocular muscles List separately in addition to code for primary procedure. Strabismus surgery on patient with scarring of extraocular muscles e. Strabismus surgery by posterior fixation suture technique, with or without muscle recession List separately in addition to code for primary procedure.

Placement of adjustable suture s during strabismus surgery, including postoperative adjustment s of suture s List separately in addition to code for specific strabismus surgery.

Orbitotomy without bone flap frontal or transconjunctival approach ; for exploration, with or without biopsy. Orbitotomy without bone flap frontal or transconjunctival approach ; with removal of foreign body. Orbitotomy without bone flap frontal or transconjunctival approach ; with removal of bone for decompression. Orbitotomy with bone flap or window, lateral approach e. Repair of blepharoptosis; frontalis muscle technique with suture or other material e.

Repair of blepharoptosis; frontalis muscle technique with autologous fascial sling includes obtaining fascia. Repair of blepharoptosis; superior rectus technique with fascial sling includes obtaining fascia. Repair of entropion; extensive e. Probing of nasolacrimal duct, with or without irrigation; with transluminal balloon catheter dilation. Tympanoplasty with mastoidectomy including canalplasty, middle ear surgery, tympanic membrane repair ; without ossicular chain reconstruction.

Tympanoplasty with mastoidectomy including canalplasty, middle ear surgery, tympanic membrane repair ; with ossicular chain reconstruction. Tympanoplasty with mastoidectomy including canalplasty, middle ear surgery, tympanic membrane repair ; with intact or reconstructed wall, without ossicular chain reconstruction. Tympanoplasty with mastoidectomy including canalplasty, middle ear surgery, tympanic membrane repair ; with intact or reconstructed canal wall, with ossicular chain reconstruction.

Tympanoplasty with mastoidectomy including canalplasty, middle ear surgery, tympanic membrane repair ; radical or complete, without ossicular chain reconstruction. Tympanoplasty with mastoidectomy including canalplasty, middle ear surgery, tympanic membrane repair ; radical or complete, with ossicular chain reconstruction.

Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material;. Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; with footplate drill out. Computed tomography, head or brain; without contrast material, followed by contrast material s and further sections. Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material.

Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material s. Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material s and further sections.

Computed tomography, maxillofacial area; without contrast material, followed by contrast material s and further sections. Computed tomography, soft tissue neck; without contrast material followed by contrast material s and further sections. Computed tomographic angiography, head, with contrast material s , including noncontrast images, if performed, and image postprocessing.

Computed tomographic angiography, neck, with contrast material s , including noncontrast images, if performed, and image postprocessing. Magnetic resonance e. Magnetic resonance angiography, head; without contrast material s , followed by contrast material s and further sequences. Magnetic resonance angiography, neck; without contrast material s , followed by contrast material s and further sequences.

Magnetic resonance imaging, brain, functional MRI; requiring physician or psychologist administration of entire neurofunctional testing. Computed tomography, thorax; without contrast material, followed by contrast material s and further sections.

Computed tomographic angiography, chest noncoronary , with contrast material s , including noncontrast images, if performed, and image postprocessing. Magnetic resonance angiography, chest excluding myocardium , with or without contrast material s.

Computed tomography, cervical spine; without contrast material, followed by contrast material s and further sections. Computed tomography, thoracic spine; without contrast material, followed by contrast material s and further sections. Computed tomography, lumbar spine; without contrast material, followed by contrast material s and further sections. Computed tomographic angiography, pelvis, with contrast material s , including noncontrast images, if performed, and image postprocessing.

Computed tomography, pelvis; without contrast material, followed by contrast material s and further sections. Computed tomography, upper extremity; without contrast material, followed by contrast material s and further sections.

Computed tomographic angiography, upper extremity, with contrast material s , including noncontrast images, if performed, and image postprocessing. Computed tomography, lower extremity; without contrast material, followed by contrast material s and further sections. Computed tomographic angiography, lower extremity, with contrast material s , including noncontrast images, if performed, and image postprocessing.

Computed tomography, abdomen; without contrast material, followed by contrast material s and further sections. Computed tomographic angiography, abdomen and pelvis, with contrast material s , including noncontrast images, if performed, and image postprocessing.

Computed tomographic angiography, abdomen, with contrast material s , including noncontrast images, if performed, and image postprocessing. Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material s and further sections in one or both body regions.

Computed tomographic CT colonography, diagnostic, including image postprocessing; without contrast material. Computed tomographic CT colonography, diagnostic, including image postprocessing; with contrast material s including non-contrast images, if performed. Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation. Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging. Cardiac magnetic resonance imaging for morphology and function without contrast material s , followed by contrast material s and further sequences;.

Cardiac magnetic resonance imaging for morphology and function without contrast material s , followed by contrast material s and further sequences; with stress imaging. Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium.

Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology including 3D image postprocessing, assessment of cardiac function, and evaluation of venous structures, if performed. Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease including 3D image postprocessing, assessment of LV cardiac function, RV structure and function and evaluation of venous structures, if performed.

Computed tomographic angiography, heart, coronary arteries and bypass grafts when present , with contrast material, including 3D image postprocessing including evaluation of cardiac structure and morphology, assessment of cardiac function, and evaluation of venous structures, if performed.

Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material s , including noncontrast images, if performed, and image postprocessing.

Placement of distal extension prosthesis s delayed after endovascular repair of descending thoracic aorta, as needed, to level of celiac origin, radiological supervision and interpretation. Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation.

Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation List separately in addition to code for primary procedure.

The healthcare data breach statistics below only include data breaches of or more records that have been reported to the U. Our healthcare data breach statistics clearly show there has been an upward trend in data breaches over the past 10 years, with seeing more data breaches reported than any other year since records first started being published by OCR. There have also been notable changes over the years in the main causes of breaches.

Better policies and procedures and the use of encryption have helped reduce these easily preventable breaches. Those breaches have resulted in the loss, theft, exposure, or impermissible disclosure of ,, healthcare records.

That equates to more than In , healthcare data breaches of or more records were being reported at a rate of around 1 per day. Fast forward 4 years and the rate has doubled. In , an average of 1. There has been a general upward trend in the number of records exposed each year, with a massive increase in These figures are calculated based on the reporting entity. When a data breach occurs at a business associate, it may be reported by each affected covered entity rather than the business associate, or the business associate may report the breach, with certain covered entities choosing to report the breach themselves.

For instance, in , The electronic health record provider, Eye Care Leaders, suffered a ransomware attack. Each covered entity reported the breach separately. That breach affected more than 25 million individuals. Certain business associate data breaches will therefore not be accurately reflected in the above table. Our healthcare data breach statistics show hacking is now the leading cause of healthcare data breaches, although it should be noted that healthcare organizations are now much better at detecting hacking incidents.

Many of the hacking incidents between occurred many months, and in some cases years, before they were detected. As with hacking, healthcare organizations are getting better at detecting insider breaches and reporting those breaches to the Office for Civil Rights.

These incidents consist of errors by employees, negligence, and acts by malicious insiders. The number of reported breaches appears to have now plateaued. Our healthcare data breach statistics show that HIPAA-covered entities and business associates have gotten significantly better at protecting healthcare records with administrative, physical, and technical controls such as encryption, although unencrypted laptops and other electronic devices are still being left unsecured in vehicles and locations accessible by the public.

HIPAA requires healthcare data, whether in physical or electronic form, to be permanently destroyed when no longer required. The improper disposal of PHI is a relatively infrequent breach cause and typically involves paper records that have not been sent for shredding or have been abandoned. Listed below are the healthcare data breaches of or more records by the entity that reported the breaches. It should be noted that data breaches at business associates may be self-reported, but could be reported by each affected covered entity.

The number of data breaches at business associates has been increasing, even not taking this reporting discrepancy into account.

The table below shows the data breaches by the reporting entity.

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Any information provided on this Website is for informational purposes only. It is not medical advice and should not be substituted for regular consultation with your health care provider. If you have any concerns about your health, please contact your health care provider's office.

Also, this information is not intended to imply that services or treatments described in the information are covered benefits under your plan. Please refer to your Membership Agreement, Certificate of Coverage, Benefit Summary, or other plan documents for specific information about your benefits coverage.

Switch to: providers brokers employers. Navigation Open. Switch to:. Careers Why Work with Us? EmblemHealth Family of Companies. A primary and specialty care practice. Well-being solutions for companies and their employees. Find a Doctor. Find Care Find a doctor, dentist, specialty service, hospital, lab and more. Telehealth About Telehealth How to Enroll. Member Sign In If you're already a member, finding the right care is as easy as signing in to your myEmblemHealth account. Sign In. Our Plans.

We've got you covered Our plans are designed to provide you with personalized health care at prices you can afford. Get a Quote. Member Resources. Live Well. Guidance on the Baby Formula Shortage As the baby formula shortage continues, there are certain precautions you should take. Learn More. Why EmblemHealth? Home Why EmblemHealth. The EmblemHealth Difference. Affordable Coverage. Our products, programs and partnerships deliver value in a number of ways, including:.

As a not-for-profit, we reinvest in our organization, members and communities. The members within the Point-of-Care program have experienced a 31 percent reduction in readmission rates and a 43 percent reduction in days hospitalized, resulting in a lower total cost of care.

The company also offers its members a variety of comprehensive wellness and disease management programs. EmblemHealth, Inc. Your email address will not be published. Save my name, email, and website in this browser for the next time I comment.

This site uses Akismet to reduce spam. Learn how your comment data is processed. August 12, Stephanie LaborPress. August 12, By Stephanie West New York, NY ó As a result of investments in coordination of patient care and expanded programs to improve quality and wellness, EmblemHealth informed New York State officials on July 31 that it would not seek premium rate increases for its HMO business, which covers , members, approximately , of whom are City employees.

August 12,

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Conviction Review Bureau. Free Educational Programs. Human Trafficking Initiative. Immigration Services Fraud Initiative. Land Bank Community Revitalization. NY Open Government. Pennies for Charity. Source of Income Discrimination. Taxpayer Protection Initiative. Contact Us. Information contained on this page may be outdated. Please refer to our latest press releases for up-to-date information. Schneiderman announced today that his office has reached a settlement with EmblemHealth, Inc.

The federal Affordable Care Act provides that families can keep their children on their family health policy until the child turns Shortly after she turned 26, the daughter received inpatient treatment, but weeks later, Emblem denied coverage, stating that she did not have insurance at the time of her hospitalization.

The investigation showed that Emblem failed to send statutorily required letters to more than 8, Emblem members between and Of these members, almost 1, were not even notified that their coverage had been terminated. EmblemHealth has agreed to send letters to affected members offering to reinstate coverage, and to reprocess and pay all unpaid claims of members who did not receive proper Age 29 notification.

But without notice of their rights under the Age 29 Law, young adults in New York have faced limited options for health coverage. The Office of Attorney General's website is provided in English. However, the "Google Translate" option may assist you in reading it in other languages. Human Trafficking Initiative. Immigration Services Fraud Initiative. Land Bank Community Revitalization. NY Open Government. Pennies for Charity. Source of Income Discrimination.

Taxpayer Protection Initiative. Contact Us. Information contained on this page may be outdated. Please refer to our latest press releases for up-to-date information. The settlement also requires the health insurance plan -- which has 3. Further information about the earlier cases can be found here and here. Under this settlement, improved services will be available to the millions of New Yorkers who are members of EmblemHealth plans.

My office will make sure that everyone, including big insurance companies, play by the rules. The federal Mental Health Parity and Addiction Equity Act, enacted in , prohibits health plans from imposing greater financial requirements or treatment limitations on mental health or substance use disorder benefits than on medical or surgical benefits. Mental and emotional well-being is essential to overall health. Every year, almost one in four New Yorkers has symptoms of a mental disorder, but less than half of those people receive treatment.

Under the agreement, EmblemHealth has agreed to provide members with an independent review of claims or requests that were denied as not medically necessary from through present, and to reimburse members for residential treatment costs that the plan did not pay due to its exclusion of coverage for this service. Since , this has resulted in thousands of its members not receiving coverage for care requested by their doctors and therapists.

The disparity is especially pronounced in more intensive levels of care. EmblemHealth excluded this type of treatment while covering similar treatment -- skilled nursing, for example -- for medical conditions. In one case, EmblemHealth denied coverage of residential treatment for a young woman with a severe case of anorexia nervosa, a potentially life-threatening condition.

In fact, Emblem members who are suffering from life-threatening withdrawal require a more intensive level of care than rehabilitation, including medically managed inpatient detoxification.

For example, Emblem improperly denied a request for coverage of substance abuse rehabilitation because the member had not recently failed an outpatient program. Members will be notified by Emblem of their eligibility for independent review of eligible claims. EmblemHealth also charges some members the higher, specialist co-payment for psychotherapy, which can deter members from seeking treatment. To assist members in accessing their behavioral health benefits, EmblemHealth will appoint full-time behavioral health advocates to help members cut through red tape, and will provide information regarding claims review and treatment options.

The Office of Attorney General's website is provided in English.

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WebJan 2, †∑ Emblemhealth's annual revenues are over $ million (see exact revenue data) and has over 1, employees. It is classified as operating in the Insurance . EmblemHealth Programs Eliminate Need for Rate Increase in NEW YORK, NY (August 6, ) ó As a result of investments in coordination of patient care and expanded programs to improve quality and wellness, EmblemHealth informed New York State officials on July 31 that it would not seek premium rate increases for its HMO business, which covers , members, approximately , of whom are City employees. WebNEW YORK - After an investigation uncovered widespread violations of New York law requiring health insurers to offer young adults continuation health coverage on their .