Internal Medicine Coding Alert
Want a Bonus? Check Out Medicare's E-Incentive
PDF
Question: We are in the process of rolling out our practice's new e-prescribing system. I have heard about Medicare's e-prescribing bonus, but how can we take advantage of it? Montana Subscriber Answer: If your internal medicine practice adopts an e-prescription system, it is eligible to earn a bonus of 2 percent of its total Medicare allowed charges. The physician does not have to register to be considered for the e-prescribing bonus -- but he must report e-prescription activity on 50 percent of the Medicare patients he sees. Reporting includes the following three G codes; select the proper code based on the encounter's specifics. Check out this guidance from "Medicare's Practical Guide to the E-prescribing Incentive Program" (www.cms.hhs.gov/partnerships/downloads/11399.pdf): • If all of the prescriptions for this patient during this visit were sent via a qualified e-prescribing system, report G8443 (All prescriptions created during the encounter were generated using a qualified e-prescribing system) *The Drug Enforcement Agency (DEA) currently prohibits e-prescribing for controlled substances. The DEA has issued a proposed rule to allow e-prescribing for controlled substances under certain conditions. Even if the DEA allows e-prescribing for controlled substances, G8446 allows you to report on the e-prescribing measure for controlled substances without using an e-prescribing system to do so. You can find more information about e-prescribing and the accompanying bonus on the CMS Web site at:
• If the provider had a qualified e-prescribing system, but did not generate any prescriptions during this encounter, report G8445 (No prescriptions were generated during the encounter, provider does have access to a qualified e-prescribing system)
• If the provider had a qualified e-prescribing system, but prescribed narcotics or other controlled substances, report G8446 (Provider does have access to a qualified e-prescribing system and some or all of the prescriptions generated during the encounter were printed or phoned in as required by state or federal law or regulations, patient request, or pharmacy system being unable to receive electronic transmission; or because they were for narcotics or other controlled substances)*
• If the provider had a qualified e-prescribing system, and state or federal law calls for him to phone in or print the prescriptions, report G8446
• If the provider had a qualified e-prescribing system, and the patient asked that you phone in or print the prescriptions, report G8446
• If the provider had a qualified e-prescribing system, and the pharmacy system can't receive electronic transmission, report G8446.
www.cms.hhs.gov/PQRI/Downloads/E-prescribingMeasureSpecifications.pdf.
Internal Medicine Coding Alert
- Capture 'Patient Limbo' Period With These Observation Coding Steps
Internist deciding on admission? That's your signal to look at observation family. You can quickly [...] - Follow This FAQ to Maximize 99291 Coding
Physician 'preventing further deterioration' keys valid critical care claims. What do critical care services need [...] - CPT 2009:
Break Down Outpatient ESRD Into These G-Code Mirroring Cat I Codes
Using these codes for inpatient dialysis will result in claim denial. Coders, take notice: Since [...] - YOU Be the Coder:
Modifiers and Holter Monitor Claims
Question: A patient who is suffering heart palpitations reports to the internist for waveform Holter [...] - Reader Questions:
Don't Sweat Global on Boot Dressing Changes
Question: A new Medicare patient with a diagnosis of postphlebitic syndrome reports to the internist [...] - Reader Questions:
Check for E/M on Non-Scheduled Procedures
Question: An established patient with osteoporosis reports to the internist with a new complaint of [...] - Reader Questions:
ID Split Visits by Spotting Shared Effort
Question: The hospital admits a 78-year-old established Medicare patient suffering from chronic obstructive pulmonary disorder [...] - Reader Questions:
Want a Bonus? Check Out Medicare's E-Incentive
Question: We are in the process of rolling out our practice's new e-prescribing system. I [...] - Reader Questions:
Use V Codes as Primary Dx -- Sometimes
Question: Our practice recently performed a three-specimen glucose tolerance test on a Medicare patient to [...]