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Issue #156 - September 1, 2010
AAPC EdgeBlast

Official EMR Credentialing Body Chosen
The Drummond Group Inc. (DGI), Austin, Texas, and the Certification Commission for Health Information Technology (CCHIT), Chicago, Ill. and were named Monday August 30 by the Office of the National Coordinator for Health Information Technology (ONC) as the first technology review bodies that have been authorized to test and certify electronic health record (EHR) systems for compliance with the standards and certification criteria that were issued by the U.S. Department of Health and Human Services (HHS) earlier this year.

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Little Time Left to Prepare for 5010 Testing
The Centers for Medicare & Medicaid Services (CMS) issued a reminder Aug. 24 to health care providers, health plans, clearinghouses, and vendors about the approaching compliance dates for the transition to the Accredited Standards Committee X12 Technical Reports Type 3, Version 005010 (Version 5010) electronic health care transaction standards. Beginning January 2011, entities covered under the Health Insurance Portability and Accountability Act (HIPAA) should be ready to test with their trading partners the functionality of the entities’ practice management and/or other related software featuring Version 5010 standards.

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NCHS Updates ICD-9 Guidelines
The Centers for Disease Control and Prevention’s (CDC’s) National Center for Health Statistics (NCHS) posted updates Aug. 5 to the ICD-9-CM Official Guidelines for Coding and Reporting. These guidelines for diagnosis coding are effective Oct. 1.

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CMS Instructs Contractors to Hold Fluzone Claims
The Centers for Medicare & Medicaid Services (CMS) is changing the payment status indicator for CPT® code 90662 Influenza virus vaccine, split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use from “E” (not paid under the Outpatient Prospective Payment System (OPPS)) to “L” (not paid under OPPS; paid at reasonable cost; not subject to deductible or co-insurance) in the October 2010 Integrated Outpatient Code Editor (IOCE).

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DCS Posts News Issues Under RAC Review
DCS Healthcare, recovery audit contractor (RAC) for Region A, posted 11 newly approved audit issues on its website mid-August. Unlike its counterpart, CGI Federal, none of the new issues include medical necessity review. Nine of the new issues are for medical severity-diagnosis related groups (MS-DRGs), another also affects inpatient claims and another affects durable medical equipment (DME) suppliers.

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Senators Ask for ASC Medicare Payment Change
Twenty-one U.S. senators sent a letter dated Aug. 5 to the Centers for Medicare & Medicaid Services’ (CMS) Administrator Donald Berwick, M.D., asking for the agency “to use its existing discretionary authority to make an important modification to the ASC payment system.”

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CMS Proposes Changes to VAD Coverage
The Centers for Medicare & Medicaid Services (CMS) is considering changes to the Medicare coverage policy for ventricular assist devices (VAD) as destination therapy in end-stage heart failure patients.

In a proposed decision memo dated Aug. 19, CMS proposes removing the requirement that patients must have a body size greater than 1.5 m² and raising the peak oxygen-consumption threshold from 12 mL/kg/min to 14 mL/kg/min.

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OIG: Physicians Generally
Miscode POS

An Office of Inspector General (OIG) review suggests physicians correctly code the place of service (POS) in Medicare Part B claims only 10 percent of the time. This pattern of incorrectly coded claims for nonfacility services resulted in Medicare overpaying physicians an estimated $13.8 million in 2007, the OIG concludes in a July report.

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CMS Expands Tobacco Cessation Counseling Coverage
Under the Affordable Care Act, the Centers for Medicare & Medicaid Services (CMS) is expanding Medicare coverage of evidence-based tobacco cessation counseling. Effective Jan. 1, 2011, any smoker covered by Medicare can receive tobacco cessation counseling from a qualified physician or other Medicare-recognized practitioner.

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Coding Tips

Ensure Proper Payment for Epidural Injections
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New DMEPOS Specialty Code for Ocularists
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Get Paid Separately for Tissue Markers, Dosimeters
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Fix Common Diagnostic Lab Coding Errors
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Palmetto Responds to Cataract Surgery LCD Comments
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Medical News

ACOG Recommends HPV Vaccine for Pre Teens
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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.

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Featured Items
EMR Credentialing
Prepare for 5010 Testing
ICD-9 Updates
Hold Fluzone Claims
DCS Posts News Issues
Medicare Payment Change
Changes to VAD Coverage
Physicians Miscode POS
Cessation Counseling
Coding Tips
Medical News
Test Yourself Online
Coding Job Links

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