PARA Weekly Update For Users October 17, 2018 by CorroHealth

PARA WEEKLY

UPDATE For Users

I mproving T he Business of H ealthCare Since 1985 O ctober 17, 2018 NEWS FOR HEALTHCARE DECISION MAKERS

IN THIS ISSUE QUESTIONS & ANSWERS - Elevated Troponin - 86617 Versus 86618 - IV Infusion Denied - Chiropractor Orders For X-Ray INFORMATIVE ARTICLES TARGETED PROBE: OUTPATIENT THERAPY CPT® CODE 97110 TARGETED PROBE J9310 RITUXIMAB REVIEW OF UNITS AND ADMINISTRATION 2019 CODING UPDATE DOCUMENTS

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New MedLearn Articles in the Advisor tab of the PARA Dat a Edit or . Click here New or revised Transmittals in the Advisor tab of the PARA Dat a Edit or . Click here.

UPDATED: 2019 MPFS PROPOSED RULE E/M PAYMENT POLICY CHANGES

Special Feature

I.T. UPDATES : NEW FEATURE! HURRICANE DISASTER RELATED CLAIMS

PARA COMPANY NEWS

SERVICES

ABOUT PARA

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Administration: Pages 1-41 HIM /Coding Staff: Pages 1-41 Laboratory Svcs: Page 2 Providers: Pages 2,3,9,24,31,37 IV Therapy Services: Page 4 Chiropractic Care: Page Outpatient Svcs: Page 6

Finance: Pages 17,25,29,34 Business Devel: Page 17 Rural Healthcare: Page 24 Long Term Care: Page 30 Compliance: Page 17 Pharmacy: Pages 8,26,37 Behavioral Health: Page 9

PARA Weekly Update: October 17, 2018

ELEVATED TROPONIN

What is the appropriate ICD-10 CM code to report for a final diagnosis of elevated troponin?

Answer: Report ICD-10CM code R79.89, other abnormal findings. The elevated troponin is considered an abnormal finding. There is not a specific code for this type of abnormal finding. Please refer to the PARA Data Editor Code descriptions for category R79.

PARA Weekly Update: October 17, 2018

86617 VERSUS 86618

We perform a screening test for Lyme Disease and charge CPT® 86618 and if positive, we send it on to a reference lab for a confirmatory Western Blot, 86617. We have recently changed to a new reference lab to performs the ?confirmatory? test, but they charge us the CPT ®86618. Our claims for two units of 86618 get denied for duplicate testing and would prefer to not have to use a modifier. Is there any reason we can?t charge the 86617 since it is confirmatory? These codes do not seem to specify methodology. Answer: The methodology is only briefly mentioned in the CPT® description for 86617, however, there are differences and we are obligated to report the test that was performed. Here are the full CPT® descriptions:

According to the Coder?s Desk Reference, the two tests have different methodologies. Here?s what it says: 86617 - This test may be ordered as a Lyme disease confirmation test. Borrelia burgdorferi is the causative agent of Lyme disease, (the vector being a tick). Antibodies usually build up in patients several weeks or longer into an infection. This test is confirmatory, meaning previous diagnostic work has been performed. Blood specimen is serum. CSF specimen is obtained by spinal puncture that is reported separately. This test reports a second test for confirmation by immunoblot or Western blot. It may also be used to establish a diagnosis following indeterminate ELISA results. 86618 - This test may be ordered simply as a Lyme disease antibody test. Borrelia burgdorferi is the causative agent of Lyme disease,(the vector being a tick). Antibodies usually build up in patients several weeks or longer into an infection. Blood specimen is serum. CSF specimen is obtained by spinal puncture, which is reported separately. Methods include enzyme-linked immunosorbent assay (ELISA), enzyme immunoassay (EIA), indirect fluorescent antibody (IFA), or specific IgG, IgM, and IgA by antibody capture. We don?t recommend changing the code that was reported by the reference lab without verifying how they performed the test. The CPT® reported needs to match the testing performed. Instead, we recommend contacting the reference lab to verify whether they performed the service ordered (western/immunoblot) or elected to perform the immunoassay (also check how the order was communicated to them ? they may have been following the order placed.) It is always possible that they reported the wrong CPT® code. And finally, Medicare?s ?Medically Unlikely Edit? (MUE) for either 86617 or 86618 is 2 per DOS, therefore it should not be a problem whether billing two units on one line (which does not require a modifier) or two lines with modifier 91 (Repeat Clinical Laboratory Test) on the second line. Incidentally, Medicare often ?packages? payments for these lab tests when reported on the same claim as other payable hospital services, such as an ED visit.

PARA Weekly Update: October 17, 2018

IV INFUSION DENIED

We have had some minor issues with payers denying infusion/injections, etc. Attached are two sample claims along with the remittance advice.

Answer: When reporting outpatient services, IV therapy must be coded for each calendar date of service with a primary code. Therefore, coding add-on HCPCS 96361 without a primary IV therapy code such as 96360 for DOS 4/2/18 will not be reimbursed. Here?s an excerpt from the claim (no PHI):

Here's an excerpt from the remittance:

We also point out that a total of ten (10) hours of hydration is unlikely. If an IV remains open at a low flow for the purpose of keeping it available should other medications be required, do not report hydration 96360 or 96361. We recommend billing hydration only if at least 500cc of hydration fluid is administered per hour. You may want to check that medical record to verify the flow rate and/or the number of cc?s of hydration fluid that was administered during the 10 hours reported with 96361.

PARA Weekly Update: October 17, 2018

CHIROPRACTOR ORDERS FOR X-RAY

Can a chiropractor order x-rays for a patient whose has commercial insurance? And, can a mid-level provider working for the chiropractor order x-rays and MRIs for both Medicare and commercial insurances?

Answer: A mid-level provider cannot order procedures and Medicare does not cover x-rays ordered by chiropractors. Another physician may order an x-ray for use by a chiropractor, but the chiropractor order does not qualify for reimbursement. Attached is a MedLearn article that discusses this point, It is written for an audience of chiropractors: https://www.cms.gov/Outreach-and-Education/ Medicare-Learning-Network-MLN/MLNMattersArticles /downloads/se0416.pdf A midlevel working for the chiropractor (such as a PA or nurse practitioner) may order plain x-rays for the chiropractor, but not an MRI. If the purpose of the MRI is to inform the chiropractor, it will not meet coverage requirements.

PARA Weekly Update: October 17, 2018

TARGETED PROBE: OUTPATIENT THERAPY CPT® CODE 97110

WPS Jurisdiction 15 would like to make providers aware they have begun a target probe into claims that are reporting CPT® 97110.

Review of medical necessity, correct billing of timed codes and all other therapy codes provided under same POC. Documentation Guidance for a Successful Review of Outpatient therapy CPT® Code(s) 97110 - Physical and/or occupational therapy initial evaluation - Diagnosis and description of problem being evaluated - Objective, measurable current functional status - Subjective patient self-report of status - Clinician's clinical judgments that describes the patient's status - Determination of the need for treatment - Physical and/or occupational therapy re-evaluation - Physician certification and recertification of the therapy plan of care - Physical and/or occupational therapy plan of care - Diagnoses - Long term measurable treatment goals - Type, amount, duration and frequency of therapy services - Physical and/or occupational therapy progress reports - Written by a clinician - Minimum progress reports are every 10 treatment days - Assessment of patient progress towards goals - Plans for continuing treatment - Changes to goals - Physical and/or occupational daily treatment notes - Physical and/or occupational therapy treatment log - Total time spent for each modality billed - Physical and/or occupational therapy discharge note - Documentation to support the services that require the skills of a therapist - Advance Beneficiary Notice of Non-Coverage (ABN), if applicable - Any additional documentation needed to support Medicare guidelines 6

PARA Weekly Update: October 17, 2018

TARGETED PROBE: OUTPATIENT THERAPY CPTÂ® CODE 97110

https://www.cms.gov/Regulations-and-Guidance/ Guidance/Manuals/Downloads/clm104c05.pdf

https://www.cms.gov/Regulations-and-Guidance/ Guidance/Manuals/Downloads/pim83c03.pdf

PARA Weekly Update: October 17, 2018

TARGETED PROBE J9310 RITUXIMAB REVIEW OF UNITS & ADMINISTRATION

WPS Jurisdiction 15 would like to make providers aware they have begun a target probe into claims that are reporting HCPCS J9310: Rituximab 100mg/unit: Review of units billed and administration.

Providers should pull patient claims and medical records in anticipation of this probe. The following criteria should be reviewed: Documentation of a covered condition that includes physician notes, historical medical records 1.Signed and legible physician orders 2.Drug administration records, specific to medication administration records, nursing treatment notes 3.Documentation must demonstrate and support the units billed and the units wasted (if applicable) 4.If the provider who ordered the Rituximab is not the same provider supervising the administration of the drug include an attestation statement from the billing provider or documentation that the billing provider supervised the administration https://www.cms.gov/Outreach-andEducation/Medicare-Learning-NetworkMLN/MLNMattersArticles/downloads /SE1316.pdf

PARA Weekly Update: October 17, 2018

2019 CODING UPDATE DOCUMENTS

M edicar e does n ot r ecogn ize Licen sed Pr of ession al Cou n selor s (LPCs) f or t h e pu r pose of pr of ession al f ee billin g. Th er ef or e, t h e ser vices of an LPC can n ot be billed t o M edicar e on a pr of ession al f ee claim in a clin ic set t in g u n less t h e ser vices ar e ?in ciden t t o? t h e ser vices of an ot h er qu alif ied pr ovider . ?Incident to? billing is fully explained in the PARA paper at https://apps.para-hcfs.com/para/Documents/Incident_to_Billing_ in_Clinic_and_Hospital_Settings_edited.pdf also available on the Advisor tab of the PARA Data Editor:

Alternately, an LPC may provide services to Medicare beneficiaries as a component of an outpatient hospital treatment program under the direction of another ?Eligible Professional? (EP). EPs include: - Physicians (medical doctors [MD] and doctors of osteopathy [DO]), particularly psychiatrists - Clinical psychologists (CP) - Clinical social workers (CSW) - Clinical nurse specialists (CNS) - Nurse practitioners (NP) - Physician assistants (PA) - Certified nurse-midwives (CNM); and Independently Practicing Psychologists (IPP)

PARA Weekly Update: October 17, 2018

UPDATED: 2019 MPFS PROPOSED RULE - E/M PAYMENT POLICY CHANGES

Significant changes for professional fee reimbursement are proposed by Medicare for 2019. The full text of the 2019 Medicare Physician Fee Schedule Proposed rule is available on the PARA Data Editor Advisor tab using the search phrase ?2019?:

For 2019, CMS estimates that the RVU conversion factor (CF) national rate will be $36.0463, a slight increase over the $35.9996 CF for 2018. Changes to Evaluation and Management payments, documentation standards, and coding. Although physicians will continue to report E/M levels using the 992XX codes, CMS proposes significant changes to payment methods in 2019. Under the proposal, Medicare will simplify payment to only one rate for 99202-99205 (new patient) and one rate for 99212-99215 (established patient). It will also provide new add-on codes for additional reimbursement for certain specialists, primary care, and prolonged E/M services. Additionally, Medicare is proposing a multiple procedure payment adjustment that would reduce the EM payment when an E/M visit is furnished in combination with a procedure on the same day. CMS also proposes to eliminate the restriction that prohibits payment of two different physicians of the same specialty practicing in the same group billing for E/M services on the same DOS. Page 370 of the Proposed Rule offers the following example to summarize the new methodology: ?As an example, in CY 2018, a physician would bill a level 4 E/M visit and document using the existing documentation framework for a level 4 E/M visit. Their payment rate would be approximately $109 in the office setting. If these proposals are finalized, the physician would bill the same visit code for a level 4 E/M visit, documenting the visit according to the minimum documentation requirements for a level 2 E/M visit and/or based on their choice of using time, MDM, or the 1995 or 1997 guidelines, plus either of the proposed add-on codes (HCPCS codes GPC1X or GCG0X) depending on the type of patient care furnished, and could bill one unit of the proposed prolonged services code (HCPCS code GPRO1) if they meet the time threshold for this code. The combined payment rate for the generic E/M code and HCPCS code GPRO1 would be approximately $165 with HCPCS code GPC1X and approximately $177 with HCPCS code GCG0X.?

PARA Weekly Update: October 17, 2018

UPDATED: 2019 MPFS PROPOSED RULE - E/M PAYMENT POLICY CHANGES

In an open letter to physicians dated July 17, 2018, CMS Administrator Seema Verma summed it up this way: ?The current system of codes includes 5 levels for office visits ? level 1 is primarily used by nonphysician practitioners, while physicians and other practitioners use levels 2-5. The differences between levels 2-5 can be difficult to discern, as each level has unique documentation requirements that are time-consuming and confusing. ?We?ve proposed to move from a system with separate documentation requirements for each of the 4 levels that physicians use to a system with just one set of requirements, and one payment level each for new and established patients. Most specialties would see changes in their overall Medicare payments in the range of 1-2 percent up or down from this policy, but we believe that any small negative payment adjustments would be outweighed by the significant reduction in documentation burden. ? ? https://www.cms.gov/Outreach-and-Education/Outreach/NPC/Downloads/ 2018-08-22-PFS-Presentation.pdf

PARA Weekly Update: October 17, 2018

UPDATED: 2019 MPFS PROPOSED RULE - E/M PAYMENT POLICY CHANGES

Physicians and qualified non-physician practitioners would continue to report the eight most common E/M codes 99202-99205 (new patient) and 99212-99215 (established patient), but Medicare?s payment and documentation rules would be simplified as follows: - Medicare payment would be at one uniform rate regardless of level for new patients, and one uniform rate regardless of level for established patients; - A new add-on G-code worth approximately $14.00 would be reported by certain specialists to facilitate additional reimbursement when reported with an E/M code billed without another procedure (available for specialists in endocrinology, rheumatology, hematology/oncology, urology, neurology, obstetrics/gynecology, allergy/immunology, otolaryngology, cardiology, or interventional pain management-centered care) - A new add-on G-code worth approximately $5.00 in reimbursement would be reported by primary care providers to earn additional reimbursement when the office visit includes primary care services - A new add-on G-code worth approximately $67.00 would be reported by providers to indicate each 30 minutes spent in face-to-face time required beyond the ?typical? time standard currently described in the CPTÂŽ code descriptions 99202-99205 and 99212-99215 - Medicare would establish two new G-codes for podiatrist visits (one for new patients, the other for established patients) which Medicare deems would overpaid if reimbursed under the uniform same new or established patient E/M payments designed for non-podiatrist providers. Payment for the two new G-codes is proposed at $22.53 for new patients, and $17.07 for HCPCS code for established patients. These values are based on the average rate for the level 2 and 3 E/M codes (CPTÂŽ codes 99201-99203 and CPTÂŽ codes 99211-99212, respectively) - Required documentation to support the uniform payment for E/M services will be streamlined to meet only one low-level E/M (99212) using either the 1995 or 1997 CMS documentation guidelines. Visits that consist predominately of counseling and/or coordination of care will use time as the key or controlling factor to qualify for a particular level of E/M services - A new multiple procedure payment adjustment would reduce the payment of the E/M code by 50% when an E/M visit is furnished in combination with a procedure on the same day (reported with modifier 25.) The multiple procedure reductions for non-E/M procedures would not change from the current policy

Physicians and qualified non-physician practitioners would continue to report the eight most common E/M codes 99202-99205 (new patient) and 99212-99215 (established patient)

PARA Weekly Update: October 17, 2018

UPDATED: 2019 MPFS PROPOSED RULE - E/M PAYMENT POLICY CHANGES

Additionally, Medicare proposes to eliminate the Group Practice E/M rule under which Medicare will deny payment of two E/Ms for same patient, same date of service when provided by two separate physicians of the same specialty working in the same medical group. This policy has caused many physician groups to require patients to schedule visits on two separate days in order that both visits can be paid. For instance, two ophthalmologists cannot both be paid for an E/M on the same patient on the same DOS, even though one ophthalmologist may super-specialize in cornea disease, and the other may specialize in retina. ?We believe that eliminating this policy may better recognize the changing practice of medicine while reducing administrative burden. The impact of this proposal on program expenditures and beneficiary cost sharing is unclear. To the extent that many of these services are currently merely scheduled and furnished on different days in response to the instruction, eliminating this manual provision may not significantly increase utilization, Medicare spending and beneficiary cost sharing.? The 2019 Medicare Physician Fee Schedule Proposed Rule is available at the following link: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched/ PFS-Federal-Regulation-Notices-Items/CMS-1693-P.html

This year, Medicare offers a slide deck presentation with highlights of their proposal: https://www.cms.gov/About-CMS/Story-Page/2019-Medicare-PFS-proposed-rule-slides.pdf

PARA Weekly Update: October 17, 2018

2019 CODING UPDATE DOCUMENTS

In preparation for the year-end CPT®/HCPCS update, PARA HealthCare Analytics is preparing a number of short, one to two- page ?coding update? documents listing deleted codes and added codes within a particular clinical area or procedure group. The coding topics addressed do not encompass all CPT® updates, only those which are most likely to be ?hard-coded? to a line item in a facility chargemaster. Topics are divided into immediately related areas, and more than one paper may contain information useful to a service line manager. Due to CPT® licensing restrictions, these documents cannot be published within the PARA Weekly Update. PARA Data Editor users may access the information on the Advisor tab; search ?Coding Update? in the type field, and/or 2019 in the subject field, as illustrated below:

Documents may be updated as we learn more information about the new codes; updates will be announced in the PARA Weekly. It is important to note that we do not have Medicare coverage information on the new codes at this time. Following the release of the OPPS Final Rule in November, coding update papers may be revised to indicate whether Medicare will accept/cover new HCPCS. PARA Data Editor Users can identify updated papers by the word ?Revised? in the title and the date issued will be updated.

PARA Weekly Update: October 17, 2018

2019 CPT® CODE SET RELEASE

PARA is in receipt of the pre-production 2019 CPT® Code Update release. In the coming weeks, our staff will begin preparing the mapping files for the January 1, 2019 coding update. The CPT® update consists of the following: - 212 Added Codes - 73 Deleted Codes - 50 Revised Codes The 2019 Appendix B (Summary of Additions, Deletions, and Revisions) is available within the PDE Calculator tab and the data is in several formats. To view the Additions, Changes, or Deletions by type, there are separate radio buttons:

PARA Weekly Update: October 17, 2018

2019 CPTÂŽ CODE SET RELEASE

An electronic copy of the Appendix B is available by clicking the ?Changes? hyperlink:

And updates to Coding Guidelines are available at the ?Guidelines? hyperlink:

When the HCPCS code update is released in November, those changes will be incorporated into the mapping files created for our clients to prepare for the January 1 implementation of new codes. If you have any questions or require assistance with the Calculator, please contact your PARA Account Executive or your Technical Support person, listed on the Select tab of the PDE. 16

PARA Weekly Update: October 17, 2018

PRICE TRANSPARENCY: PATIENT SHARE OF COST WIDGET

Price Transparency Tools: -

Keep hospitals in compliance - Locate lost charges - Provide local price comparisons Get out in front of public scrutiny of prices

The tool developed by PARA HealthCare Analytics - Compares your hospital to peer groups of your choice - Compares inpatient service line and outpatient CPTÂŽ code-specific charges - Compares departmental charges within service lines

The following article details just how PARA's Price Transparency Tool can help you stay ahead of the curve. 17

PARA Weekly Update: October 17, 2018

PRICE TRANSPARENCY: PATIENT SHARE OF COST WIDGET

BACKGROUND Pricing transparency continues to be an important topic in the healthcare industry. Healthcare professionals are working to understand how pricing transparency can improve Patient satisfaction and reduce hospital bad debt. The benefits of providing cost estimates prior to scheduling services include: - Providing pricing transparency - Provide estimates prior to service, avoiding unexpected financial liability - Reduce Patient dissatisfaction directed at the provider - Increase self-pay collections while decreasing bad debt Today?s Patients are becoming informed consumers through a variety of channels including media exposĂŠs on healthcare costs and the continued progress of the Affordable Care Act. Patients require a clear picture of their financial obligation for services. Informing Patients of the cost of services is in the best interest of the facility. Although generating a quote for services involves a variety of contractual discounts and health insurance plan information, some information can be readily available to the Patient with minimal employee intervention. The PARA Patient Share of Cost Estimator Widget allows the patient to determine their cost from a provider-based web portal.

PARA Weekly Update: October 17, 2018

PRICE TRANSPARENCY: PATIENT SHARE OF COST WIDGET

THE PARA SOLUTION The PARA Patient Share of Cost Estimator Widget provides facilities with a system for generating patient quotes of the top procedures for the facility. Details of this project including purpose, method, timeline, and deliverables are as follows. If you would like more information, please contact your Account Executive. PURPOSE: The purpose of the PARA Patient Share of Cost Estimator Widget is to create a web-based system that allows the Patient to determine their share of cost for healthcare services. METHOD: PARA will review your current website design structure to create a patient cost estimator widget mirroring the look and structure of your current website. The PARA Patient Share of Cost Estimator Widget provides the patient an easy to use decision tree to select the services required.

PARA Weekly Update: October 17, 2018

PRICE TRANSPARENCY: PATIENT SHARE OF COST WIDGET

PARA will provide your facility a suggested list of services based on trends of the most recent Medicare Data available including: -

Top 25 Inpatient Medicare DRG Data Top 20 ICD10 Diagnoses for ED Level Charges New and Established Patient Level Samples Mammography Charges EKG/Stress Test Charges Top 15 Laboratory Procedures Top 15 Radiology Procedures Other Service Lines (as requested by client)

PARA will develop custom procedure categories and subcategories based on the facility-approved list of services and will develop and provide the implementation instructions for facility and designated employers for immediate deployment. Initial and ongoing training and support for the duration of the agreement for employers and facility are provided.

PARA Weekly Update: October 17, 2018

PRICE TRANSPARENCY: PATIENT SHARE OF COST WIDGET

DELIVERABLES PARA will provide your facility a web based control panel to allow updates and changes to the estimator on an ongoing basis (i.e. update prices, change benefit plans, add services, etc). PARA will provide an optional insurance and benefit plan allowing any patient to enter their own benefit information to calculate their cost. PARA will provide Medicare and Medicaid terms (where applicable) allowing patients to calculate their cost, and will incorporate the Hospital?s self-pay discount to allow self-pay patients to calculate their cost.

PARA will provide an option for the price estimate to be emailed to the patient or printed and will provide links and referrals to financial counseling, charity care policies, quality ratings, patient satisfaction scores, and other information deemed pertinent by the hospital. PARA will provide an internal web based tool to the provider to review all estimates created by patients.

PARA Weekly Update: October 17, 2018

PRICE TRANSPARENCY: PATIENT SHARE OF COST WIDGET

PARA Weekly Update: October 17, 2018

PRICE TRANSPARENCY: PATIENT SHARE OF COST WIDGET

The PARA Patient Share of Cost Estimator Widget statistics can be tracked in the PARA Data Editor (PDE) according to general use, visits by date, top estimates by service, and estimates by insurance.

INVESTMENT The PARA Patient Share of Cost Estimator Widget has an initial set-up cost of $13,000 with subsequent maintenance fees each year depending on the updates required. CONTACT Violet Ar ch u let a-Ch iu

San dr a LaPlace

Senior Account Executive

Account Executive

varchuleta@para-hcfs.com

slaplace@para-hcfs.com

800-999-3332 ext. 219

800-999-3332 ext. 225

PARA Weekly Update: October 17, 2018

RURAL HOSPITAL PROGRAM GRANTS AVAILABLE

Rural hospitals and clinics face their own set of unique and burdensome challenges when it comes to program development, cash management and maintaining volume. That's why it's great when they can get some assistance from external funding sources. At PARA, we've found an excellent source of funding opportunities for rural healthcare facilities. Here are some examples.

Healthy Start: Eliminating Disparities In Prenatal Health - Provides up to $950,000 for each of five years for programs that improve access to quality healthcare and services for women, infants, children, and families through outreach, care coordination, health education, and linkage to health insurance - Strengthen the health workforce, specifically those individuals responsible for providing direct services - Application Deadline: November 27,2018

HRSA Remote Pregnancy Monitoring Challenge Grant - Provides up to $150,000 to support technological solutions to help prenatal care providers remotely monitor the health and well being of pregnant women - Priority is given to benefit women in rural and medically underserved areas. - Application Deadline: November 27, 2018

Small Rural Hospitals Improvement Program (SHIP) - Provides $12,000 for each of four years to help hospitals with 49 or fewer beds to purchase hardware, software and training - To join or become accountable care organizations and/or create shared savings programs - Purchase health information technology, equipment or training to comply with quality improvement activities. - Application Deadline: January 3, 2019 24

PARA Weekly Update: October 17, 2018

MLN CONNECTS

SPECIAL EDITION Hu r r ican e M ich ael an d M edicar e Disast er Relat ed Flor ida an d Geor gia Claim s M LN M at t er s Ar t icle ? Revised The President declared a state of emergency for the states of Florida and Georgia, and the HHS Secretary declared a Public Health Emergency, which allows for CMS programmatic waivers based on Section 1135 of the Social Security Act. A revised MLN Matters Special Edition Article on Hurricane Michael and Medicare Disaster Related Florida and Georgia Claims is available. Learn about blanket waivers CMS issued for the impacted geographical areas. These waivers will prevent gaps in access to care for beneficiaries impacted by the emergency. This article was revised to add information regarding the emergency declared for the state of Georgia.

PARA Weekly Update: October 17, 2018

MLN CONNECTS

PARA invites you to check out the mlnconnects page available from the Centers For Medicare and Medicaid (CMS). It's chock full of news and information, training opportunities, events and more! Each week PARA will bring you the latest news and links to available resources. Click each link for the PDF!

Thursday, October 11, 2018 New s & An n ou n cem en t s

· New Medicare Card: Destroy the Old Card · CMS to Strengthen Oversight of Medicare?s Accreditation Organizations · Participants in New Value-Based Bundled Payment Model · Medicare Diabetes Prevention Program: New Covered Service · Part A Providers: MCReF System Enhancement · Protect Your Patients from Influenza this Season Pr ovider Com plian ce

· Proper Use of the KX Modifier for Part B Immunosuppressive Drug Claims ? Reminder Claim s, Pr icer s & Codes

· Reprocessing Claims for Diagnostic Services by Certain PTs Upcom in g Even t s

· Submitting Your Medicare Part A Cost Report Electronically Webcast ? October 15 · Patient Relationship Categories and Codes Webcast ? October 17 · Physician Compare: Preview Period and Public Reporting Webcast ? October 30 M edicar e Lear n in g Net w or k ® Pu blicat ion s & M u lt im edia

· LCDs MLN Matters Article ? New · Ensuring OC 22 is Billed Correctly on SNF Inpatient Claims MLN Matters Article ? New · HCPCS Codes for SNF CB: 2019 Annual Update MLN Matters Article ? New · Medicare Diabetes Prevention Program Call: Audio Recording and Transcript ? New

PARA Weekly Update: October 17, 2018

IT WEEKLY UPDATE

PARA HealthCare Analytics has provided a list of enhancements and updates that our Information Technology (IT) team has made to the PARA Data Editor this past week. This is a NEW Weekly Feature. The following table includes which version of the PDE was updated, the location within the PDE, and a description of the enhancement.

Week ly IT Updat e

PARA Weekly Update: October 17, 2018

There were THREE new or revised Med Learn (MLN Matters) articles released this week. To go to the full Med Learn document simply click on the screen shot or the link.

FIND ALL THESE MED LEARNS IN THE ADVISOR TAB OF THE PDE

PARA Weekly Update: October 17, 2018

The link to this Med Learn SE18021

PARA Weekly Update: October 17, 2018

The link to this Med Learn MM10869

PARA Weekly Update: October 17, 2018

The link to this Med Learn SE18023

PARA Weekly Update: October 17, 2018

There were EIGHT new or revised Transmittals released this week. To go to the full Transmittal document simply click on the screen shot or the link.

FIND ALL THESE TRANSMITTALS IN THE ADVISOR TAB OF THE PDE

PARA Weekly Update: October 17, 2018

The link to this Transmittal R2144OTN

PARA Weekly Update: October 17, 2018

The link to this Transmittal R2152OTN

PARA Weekly Update: October 17, 2018

The link to this Transmittal R307FM

PARA Weekly Update: October 17, 2018

The link to this Transmittal R2151OTN

PARA Weekly Update: October 17, 2018

The link to this Transmittal R834PI

PARA Weekly Update: October 17, 2018

The link to this Transmittal R833PI

PARA Weekly Update: October 17, 2018

The link to this Transmittal R835PI

PARA Weekly Update: October 17, 2018

The link to this Transmittal R183SOMA

PARA Weekly Update: October 17, 2018