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Issue #132 - September 2, 2009
AAPC EdgeBlast

CMS to Host Third Education Call on 5010
The mandatory compliance date for Medicare’s Fee-for-Service (FFS) implementation of Health Insurance Portability and Accountability Act (HIPAA) version 5010 is Jan. 1, 2012; however, providers will be able to test the new software and transition to version 5010 as early as Jan. 1, 2011. Are you ready?

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H1N1 Vaccine HCPCS Codes Released
Two new Level II HCPCS codes were added to the 2009 Medicare Physician Fee Schedule Database (MPFSDB) in the October update. Effective Sept. 1, report code G9142 Influenza A (H1N1) vaccine, any route of administration to describe the H1N1 vaccine itself, and G9141 Influenza A (H1N1) immunization administration (includes the physician counseling the patient/family to describe the administration of the H1N1 vaccine.

Providers should report one unit of G9141 for each administration of the H1N1 vaccine.

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HIPAA Mandates PHI Breach Notification
Health care providers, health plans, and other entities covered under the Health Insurance Portability and Accountability Act (HIPAA) will soon be required to notify individuals in the event their unsecured personal health information (PHI) is breached. The U.S. Department of Health and Human Services (HHS) published an interim final rule Aug. 24 providing new regulations regarding the HIPAA notice of breach requirements.

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Value-Based Purchasing Demos Pay Off
The Centers for Medicare & Medicaid Services (CMS) announced Aug. 17 new results from three of its demonstrations and the start of three additional value based purchasing demonstrations.

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Group Questions 2010 Proposed Radiation Tx Rates
A new proposal from the Centers for Medicare & Medicaid Services (CMS) to cut payments for radiation therapy treatments would cause many cancer centers to close, stop accepting Medicare patients, lay off support staff, and reduce services to cancer patients, according to a survey conducted by the American Society for Radiation Oncology (ASTRO).

On July 13, CMS announced in the Medicare Physician Fee Schedule (MPFS) proposed rule for 2010 proposed changes to Medicare policies and payment rates for physician services, including radiation oncology, that would cut payments to radiation therapy services by nearly 20 percent.

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Bevacizumab Reimbursed by Medicare
HCPCS Level II code Q2024 Bevacizumab injection will be reimbursed by Medicare effective October 1. Distributed under the trade name Avastin, the drug inhibits angiogenesis — the uncontrolled spread of blood vessels feeding cancer tumors and diabetic retinal proliferation in the eye.

To help you code this drug, which is often administered in concert with a chemotherapeutic drug, the code’s status indicator is “E,” which means Bevacizumab is excluded from the Medicare Physician Fee Schedule Data Base (MPFSDB) by regulation and has no relative value listed, but is paid under reasonable charge procedures. Type of service (TOS) codes are “1″ (Medical Care) and “P” (lump sum purchase of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies or DMEPOS).

Read the Centers for Medicare & Medicaid Services (CMS) Transmittal 1805 to learn more.

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Coding Tips
UnitedHealthcare Increases Rapid Flu Test Fee
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FDA Approves New Waived Tests
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Third RAC Posts CMS-Approved Issues
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In-Office Coumadin Coding Made Easy
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Medical News

FDA Issues Glucose Monitoring Technology Alert
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CDC Releases New Flu Preparedness Guidance
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New Obesity Medicine Physician Certification
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Do You Have an EMR Story?
Do any of you have a story to tell about the purchase of an EMR system for your practice? How long did it take to install? How much did it cost? Was it easy to use? Has it accomplished what you wanted? Are your physicians seeing the same, more or less patients per day since? Do the physicians like it? We’d love to hear from you! Please send your stories directly to reed.e.pew@aapc.com

Test Yourself Online
The Test Yourself questions can be accessed online at www.aapc.com/testyourself/. Once you go there and take the test, you can automatically grade your answers, correct any mistakes, and have your CEUs automatically added to your CEU Tracker for submission.

Coding Job Links
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Featured Items
Third Education Call
H1N1 Vaccine Codes
PHI Breach Notification
Value-Based Purchasing
Radiation Tx Rates
Bevacizumab Reimbursed
Coding Tips
Medical News
Test Yourself Online
Coding Job Links

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