Tri-Cities March 2010 Coding Class

Ingenix Clinical Assessment Solutions is offering a coding class focused on chronic condition coding for the Medicare population with specific information pertaining to ICD-9 coding. The class has been approved by the American Academy of Professional Coders and offers four (4) Continuing Education Credits (free) for each attendee completing the class. The course provides hands-on practice and useful coding tips and tools for each attendee. The coding class would be extremely helpful for staff of medical practices participating in Medicare Advantage products through HPI/HWHN. The class is scheduled Tuesday, March 9, 2010, 12:00 p.m. – 4:30 p.m. (Eastern Time) at Johnson City Medical Center -7th Floor, Auditorium #3. For more information and to register for this class please contact Kristy Renfroe at kristy.renfroe@ingenix.com prior to March 3rd. Registration is required due to limited seating. There is No Cost to attend the class and remember to bring your current ICD-9 Coding Book.

Please click here for details.

Two Specialty Webinars Scheduled In March - Medicare Allowable & Medicare Preventative Services

Cahaba GBA will be hosting two specialty webinar events during the month of March. These events will feature education on how the Medicare physician fee allowable amount is calculated and the various types of preventive services offered by the Medicare Program. Details of the events include:

Title:Show Me the Medicare Allowable
Date: March 16, 2010
Time: 1:30 pm – 2:30 pm ET

Title:Medicare Preventive Services
Date: March 24, 2010
Time: 11:00 am – 12:00 pm ET

In order to receive the audio/web conference code instructions, you must register for the event. It is important to note that if you are planning to sit in with a group, only one person needs to register to receive the call-in instructions. Space is limited, so please take advantage of this opportunity and register early on our Calendar of Events web page at https://www.cahabagba.com/apps/course_registration/al/calendar.jsp

Update on Claims Processing for Ordering/Referring Providers

The Centers for Medicare & Medicaid Services (CMS) will delay until January 3, 2011, the implementation of Phase 2 of Change Request (CR) 6417 (Expansion of the Current Scope of Editing for Ordering/Referring Providers for Claims Processed by Medicare Carriers and Part B Medicare Administrative Contractors (MACs)) and CR 6421 (Expansion of the Current Scope of Editing for Ordering/Referring Providers for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Supplier Claims Processed by Durable Medical Equipment Medicare Administrative Contractors (DME MACs)).

This delay will give physicians and non-physician practitioners who order items or services for Medicare beneficiaries or who refer Medicare beneficiaries to other Medicare providers or suppliers sufficient time to enroll in Medicare or take the action necessary to establish a current enrollment record in Medicare prior to Phase 2 implementation.

Although enrolled in Medicare, many physicians and non-physician practitioners who are eligible to order items or services or refer Medicare beneficiaries to other Medicare providers or suppliers for services do not have current enrollment records in Medicare. A current enrollment record is one that is in the Medicare Provider Enrollment, Chain and Ownership System (PECOS) and contains the NPI. Under Phase 2 of the above referenced CRs, a physician or non-physician practitioner who orders or refers and who does not have a current enrollment record that contains the NPI will cause the claim submitted by the Part B provider/supplier who furnished the ordered or referred item or service to be rejected.

CMS continues to urge physicians and non-physician practitioners who are enrolled in Medicare but who have not updated their Medicare enrollment record since November 2003 to update their enrollment record now. If these physicians and non-physician practitioners have no changes to their enrollment data, they need to submit an initial enrollment application which will establish a current enrollment record in PECOS.

Liability by locality: Practical standard or outdated notion?

Some say an old rule for deciding negligence by local, versus national, care standards protects rural medicine. Others say it invites risks.
Click here to read full article.

Health spending growth at lowest recorded rate

National overall health spending in 2008 increased by only 4.4%, and growth in spending on physician services -- 5% -- is at the slowest rate since 1996.
Click here to read full article.

CMS unveils plan for how doctors, hospitals can get EMR incentives

Some organizations worry about the speed at which health professionals are expected to move in adopting EMR capabilities. Click Here for the full story.

The Centers for Medicare & Medicaid Services (CMS) - HIPAA Version 5010 Updates

New from the Medicare Learning Network (MLN): The Centers for Medicare & Medicaid Services (CMS) has released two new HIPAA Version 5010 fact sheets, as well as two companion checklists, to assist providers in transitioning to 5010.

Version 5010 is the new version of the X12 standards for HIPAA transactions; version D.0 is the new version of the National Council for Prescription Drug Program (NCPDP) standards for pharmacy and supplier transactions; and version 3.0 is a new NCPDP standard for Medicaid pharmacy subrogation.

The implementation of HIPAA Version 5010 presents substantial changes in the content of the data that providers submit with their claims, as well as the data available to them in response to their electronic inquiries for eligibility or claims status. These new educational materials inform providers of these changes and how they need to plan for their implementation. This information is designed for Medicare Fee-For-Service providers; however, it may be of interest to all health care providers. Go to the CMS 5010 website at http://www.cms.hhs.gov/Versions5010andD0/ and click on “Educational Resources” to view these new educational products.

"Wellmont taps veteran Burgin for interim CEO post"

According to a press release from Wellmont Health Systems, a retired healthcare executive will provide interim leadership as Wellmont continues its national search for their next chief executive.

Bob Burgin, a retired healthcare executive who served for more than two decades as president and CEO of Mission Hospitals in Asheville, N.C., has assumed the responsibilities of interim CEO. Burgin has been as a member of the Wellmont board of directors since July 2009.

Outgoing President and CEO Mike Snow, will leave the system later this month to become chief operating officer of Amedisys Inc.

“Bob’s exemplary record at Mission speaks for itself, and he has demonstrated a keen understanding of the opportunities and challenges facing our hospitals during his tenure on the Wellmont board,” said Roger K. Mowen Jr., board chairman. “His experience as a Wellmont board member enables him to hit the ground running, which is a tremendous benefit to our organization and the patients we serve.

“Bob is an experienced leader who will provide strong, steady leadership for our health system during this time of transition.”

With Burgin’s selection as interim CEO, Mowen said, the Wellmont board of directors will now turn its attention to a national search for a permanent president and CEO. The board will work with an executive search firm to identify and select a top candidate, a process expected to be complete within six months.

Click here to read the full Johnson City Press article from February 2, 2010.

Above quoted from http://timesnews.net/article.php?id=9020259

Revised Medicare Physician Fee Schedule Fact Sheet

The Medicare Physician Fee Schedule Fact Sheet (February 2010) has been revised to include information about the two month zero percent (0%) update to the 2010 Medicare Physician Fee Schedule (MPFS) effective only for dates of service January 1, 2010 through February 28, 2010. This fact sheet, which also provides information about MPFS payment rates and the MPFS payment rates formula, is available in downloadable format from the Centers for Medicare & Medicaid Services Medicare Learning Network at: http://www.cms.hhs.gov/MLNProducts/downloads/MedcrePhysFeeSchedfctsht.pdf