May 2011 May 2011
Federal Incentive Plans Attestation for Medicare EHR Incentive Program began April 18th! Eligible professionals (EPs) can attest through CMS web-based attestation system. Are you an eligible professional? Find out here. Register for Attestation here. The Meaningful Use Attestation Calculator. Step-by-step guidance on attestation process in the Attestation User Guide.
DEADLINE Approaching… At least 10 unique encounters must be submitted to CMS prior to June 30, 2011 to be exempt from the 2012 eRx payment adjustment. Get started here.
A List of EHR Vendors with PQRS and eRx Capabilities was released by CMS. See this page for details.
There is new guidance on Privacy Rules and facilitating electronic exchange of health information. The Office for Civil Rights (OCR) published new HIPAA Privacy Rule guidance documents as part of a Privacy and Security Toolkit.
The Certified HIT Product List (CHPL) provides a comprehensive listing of Complete EHRs and EHR Modules that have been tested and certified.
UPDATE CMS allows a third-party to register on behalf of an EP if they have an Identity and Access Management System (I&A) web user account and be associated to the EP's NPI. Visit I&A Security Check to create an account. States regulations may vary. Check with your state to see what functionality will be offered.
AmericanEHR provides tools to help identify, implement, and effectively use EHRs and other healthcare technologies for free. They also offer an EHR Readiness Tool 1
Practice Federal News Management & NO Accreditation Required! CMS states, "MIPPA expressly excludes from the C o d i n g E d u c a t i o n a l accreditation requirement x-ray, ultrasound..." This link gives the actual CPT codes from CMS that require accreditation. Opportunities for 2011 Are you aware of the implications of not being ready for the implementation of versions 5010 and D.0? Find more information.
All courses Who needs to know about Medicare FFS’ implementation of 5010?
How to Prepare for an Audit Live Webinar Series July 13th & July 27th 12:00 p.m. – 1:30 p.m.ET
Find out whom the auditors are, why they are auditing your practice, what information they are looking for and what is required for documentation. More information
All Medicare FFS trading partners who are considered to be HIPAA covered entities, their business associates, and anyone expecting to implement ICD-10. HIPAA standards
New tools are available from the government to help fight fraud and abuse. Examples are: Tough New Rules and Sentences for Criminals Enhanced Screening and Other Enrollment Requirements New Focus on Compliance and Prevention 2 o The Affordable Care Act also requires providers, suppliers, Medicare Advantage plans, and Part D plans to report and return Medicare and Medicaid overpayments within 60 days of identification.
How much do you really know about ABNs? Look here for all ABN information
Charting a Course for ICD10 July 28 & 29th
Jacksonville, Florida
The transition to ICD-10 takes effect in October 2013 – and CMS has indicated that there will be no delay. It's time to start planning now! Limited Seating! More information
20 Tips to Prevent Medical Errors Fact Sheet. Estimates indicate that as many as 44,000 to 98,000 people die each year as the result of medical errors totaling more than motor vehicle accidents, breast cancer, or AIDS deaths.
All Physician Assistants require a supervising physician and each state has different requirements for physician co-signatures, supervising multiple PAs, and appropriate methods of supervision. The American Academy of Physician Assistants provides more information.
What are the HIPAA guidelines for sharing PHI (personal health information) in emergency situations such as the recent flooding in the US?
Bridge Gaps in Endocrine Coding August 13th
Chicago, IL
This one-day course is for experienced coders and will cover: Components of a Medical Record Fine Needle Aspirations Injections & Infusions Nurse Visits E/M Codes and when to utilize with procedures And more! More information
The Pre-Existing Condition Insurance Plan (PCIP) makes health coverage available to patients who have been denied health insurance by private insurance companies because of a pre-existing condition.
Free compliance training is being offered by HHS and the OIG. Are you interested in learning about the fundamentals of health care compliance? Do you know what to do when a compliance issue arises? The training will be available for online viewing on or before May 31, 2011.
OIG Advisory Opinion List provides meaningful advice on the application of the anti-kickback statute and other OIG sanction statutes in specific factual situations. Please note, however, that advisory opinions are binding and may legally be relied upon only by the requestor according to their web site information here. 2
(Almost) Everything You Need to Know About Those Incentive Programs August 26th
Ft. Lauderdale, FL
Is your Medicare patient population 30% or greater? If so, you are looking at a reduction of Medicare reimbursements by as much as 5% of your total Medicare allowable charges due to lack of participation in CMS’ incentive programs.
Allied Health Professional (AHP) Subscription Program AACE now offers subscriptions for Allied Health Professionals (AHPs) who are not members of AACE, but would like to participate in a wide range of AACE educational activities and services that may be useful in their ongoing practice, educational and professional needs. What are the benefits of being an AHP subscriber?
Are you curious about what to pay your new employees? As an AACE AHP member, you can receive complimentary detailed compensation reports that are customized to your practice’s unique needs. Find out what total compensation and benefits are typically offered in your local market so that your practice can be more competitive.
Access to the members section of the AACE Web site, which offers educational, clinical, and practice-related resources such as: o Affordable access to e-learning and video training programs for your office o Assistance with coding and billing issues with all payers o Discounts on office furniture and supplies o Apparel for healthcare professionals and office staff o Financial resources and services
Attendance at AACE educational programs at discounted rates
Online access to Endocrine Practice and The First Messenger, publications designed for clinical endocrinologists.
More information
Certified Medical Office Manager September 15-18th
Richmond, VA
Objectives include:
Defining budget guidelines, terminology, and financial policies Demonstrating effective communication on financial projections Defining ways to control practice expenses and set cost control goals Reviewing effective strategies on billing and collecting Explaining how to use medical records in malpractice suits Defining current HIPAA and OIG compliance statues
Who can be an AACE subscriber? A non-physician Allied Health Professional who meets the established eligibility requirements for each category listed below:
AHP not employed or affiliated with an AACE member or CAP employee AHP employed by an AACE member AHP affiliated (but not employed) with an AACE member AHP employee of AACE Corporate Advisory Partner (CAP) member
How much is the annual subscription fee? AHP Subscribers: $100 For more information go to www.aace.com or contact afolsom@aace.com.
And much more!
EmPower Magazine is a free, 32-page, quarterly periodical, written with the Additional Information
patient in mind. The articles focus on endocrine conditions such as diabetes, thyroid dysfunction and many other endocrine conditions, and address the importance of disease management and prevention. Articles are written by expert endocrinologists with years of clinical experience, but are written in a way that is easy for patients to read and understand. Copies of the magazine are available for free. For more information, visit www.empoweryourhealth.org. 3
MGMA calls on practice administrators to complete a brief questionnaire regarding the progress medical practices have made in preparing for the government mandate requiring all covered entities to convert from the current HIPAA Version 4010 electronic transaction standards to Version 5010 by Jan. 1, 2012. MGMA has been asked to testify before a federal advisory body on the issue of industry Version 5010 readiness. The results of this research will be incorporated into MGMA’s testimony.
ACP has partnered with other leading health advocacy organizations to launch a new consumer web site on the Affordable Care Act. Check it out here.
What is Data Breach Insurance? See this article by amednews staff. Examples of ways to streamline processes and eliminate waste in the office-see this article by Matthew Vuletich
Subscribe to United Healthcare’s Network Bulletin for free! This bulletin is designed to share updates regarding UHC’s policy and procedure changes as well as important clinical and administrative information.
Bankrupt patients: What's a practice to do? By Matthew Vuletich, MGMA senior writer/editor Specializing in medical graphic designs, AACE Impact Graphics is nationally recognized from a medical association you can trust. You only have a few seconds to catch a client’s attention. Call 1-800-393-2223 for more information or go to AACE Impact Graphics
AES specializes in the development and management of continuing medical education programs, including the development and distribution of enduring educational materials. Call 1-800-393-2223 for more information or go to AACE Educational Services - AES
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Drug codes may require units. An example is Reclast (Zoledronic acid). Code J3487 is for 1mg. If the physician prescribes 2mg, J3487 would be used with two units. VERIFY reimbursement is made on two units. Coding and billing systems may not recognize a discrepancy in reimbursement with units. If the carrier paid one unit correctly based on the fee schedule, the other unit/money may be written off. This could cost you money!
All offices that have participated in the eRx (electronic prescribing) should follow up to ensure that your software and/or your vendor’s software allowed the G code to transmit to Medicare with a $0 fee amount. Some software programs do not allow transmittals of $0 fee amounts.
Trailblazer, a local carrier for CMS, has great tips for minimum documentation requirements for various services. Go to this link and select the “I accept” button
Per CMS’ Medicare Unlikely Edits (MUEs) CPT code 76942 (ultrasound guidance for needle placement…) and 76536 (Ultrasound, soft tissues of head and neck, real time with image and documentation) should only be reported one time per episode of care.
All medical coding must be supported with documentation and medical necessity. **While this document represents our best efforts to provide accurate information and useful advice, we cannot guarantee that third-party payers will recognize and accept the coding and documentation recommendations. As CPT®, ICD-9-CM and HCPCS codes change annually, you should reference the current CPT®, ICD-9-CM and HCPCS manuals and follow the "Documentation Guidelines for Evaluation and Management Services" for the most detailed and up-to-date information. This information is taken from publicly available sources. The American Association of Clinical Endocrinologists cannot guarantee reimbursement for services as an outcome of the information and/or data used and disclaims any responsibility for denial of reimbursement. This information is intended for informational purposes only and should not be deemed as legal advice, which should be obtained from competent local counsel. Current Procedural Terminology (CPT©) is copyright and trademark of the 2010 American Medical Association (AMA). All Rights Reserved. No fee schedules, basic units, relative values, or related listings are included in CPT©. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply to government use. 4