Part B Insider (Multispecialty) Coding Alert

Published on Wed Aug 24, 2005 PDF

But you'll need to contact a vendor to install it

For once, the Centers for Medicare & Medicaid Services stuck to a deadline ...quot; and proved the naysayers wrong.
In the face of rumors that CMS would delay the release of the mostly free electronic health record (EHR) software VistA-Office to physician offices, CMS announced that the software was ready. You can't obtain the software directly from CMS right now, however ...quot; you have to obtain it from a "qualified vendor," who'll need to be paid for helping to install it.
The software comes with other costs as well, CMS cautions in a Sept. 19 release. For one thing, you have to pay to license the American Medical Association's database of CPT code descriptors and the database that comes with the software. If you want the software on computer disk, you'll have to pay for that too. Vista-Office is an adaptation of software that the Veterans Health Administration uses. CMS is testing the software to see how well it works in physicians' offices, and how well it plays with other software you may already have. The new version of Vista-Office supports order entry, documentation templates and clinical reminders, as well as patient registration, quality measure reporting and prescription printing and faxing.
You can find out more by visiting www.vista-office.org or www.worldvista.org.
In other news:
• Part B carrier TrailBlazer Health Enterprises paid 15 providers $35,000 for arterial stents that didn't meet Medicare reimbursement requirements, according to a recent report from the HHS Office of Inspector General (OIG).
The OIG said program safeguard contractor TriCenturion looked at 72 arterial stent claims and found 20 of them were improper. These included four claims that lacked medical necessity documentation, nine claims that didn't support the services the physicians documented, and seven claims that included improper coding.
• Another OIG report complains that CMS and the Health Resources and Services Administration (HRSA) aren't doing enough to make sure rural health clinics really are in rural areas. Fully 110 RHCs are in urban areas and another 169 clinics are in areas that haven't been designated shortage areas, the OIG says.
• CMS instructs the carriers to add a "collection number" assigned by the Office of Management and Budget to all Additional Documenta-tion Requests the carriers send out, in Transmittal 122, dated Sept. 16. And Transmittal 679, dated Sept. 16, instructs the carriers to get ready to deal with the new "reconsideration" process, in which you can appeal claims to the new Qualified Independent Contractors.