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Issue #162 - December 1, 2010
AAPC EdgeBlast

Congress Passes Bill to Postpone Physician Pay Cut
A 23 percent cut in Medicare payments to physicians scheduled to take effect Dec. 1 has been postponed for one month. The U.S. House of Representatives agreed without objection Nov. 29 to an amended bill the Senate unanimously passed Nov. 18. President Barack Obama is expected to sign the bill. The Physician Payment and Therapy Relief Act of 2010 (HR 5712) as amended by Senate Amendment (SA) 4711 extends the 2.2 percent physician payment update that expired Nov. 30 through Dec. 31.

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Ventricular Assist Device Conditions Expand
The Centers for Medicare & Medicaid Services (CMS) has expanded the conditions for coverage of Ventricular Assist Device (VAD) as Destination Therapy. Medicare covers VADs for three general indications: 1) postcardiotomy; 2) bridge to transplantation; and 3) destination therapy.

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10% Raise for Primary Care
Physicians who continue providing primary care services to Medicare patients stand to get a 10 percent pay raise under the health reform act. Increasing medical costs and decreasing Medicare reimbursement rates have put a lot of physician practices in a financial bind. To stay afloat, many physicians have made the difficult decision to stop accepting Medicare patients. The Patient Protection and Affordable Care Act of 2010 (commonly referred to as the Affordable Care Act) includes a provision to turn this trend around by offering incentive payments to physicians and non-physician practitioners (NPPs) who continue to provide primary care services to Medicare patients.

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New Innovation Center, Demonstrations
The Centers for Medicare & Medicaid Services (CMS) announced the establishment of the new Center for Medicare and Medicaid Innovation (CMMI or Innovation Center). A provision of the Patient Protection and Affordable Care Act of 2010 (commonly referred to as the Affordable Care Act), the Innovation Center will examine new ways of reducing health care delivery costs without jeopardizing quality of care. CMS also announced the launch of two new demonstration projects that will test "health home" and "medical home" concepts.

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Docs Asked to Report Safety Issues to EHRevent
Health care providers have a new vehicle to use for reporting adverse events related to electronic health record (EHR) implementation and use. EHRevent is a new safety event reporting system, recently launched by iHealth Alliance, and designed to improve EHR and patient safety and help reduce professional liability.

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New Rules Slash Improper Pay
The Medicare Fee for Service (FFS) error rate dropped from 12.4 percent in 2009 to 10.5 percent, or $34.3 billion, in estimated improper claims payments for 2010, according to the Centers for Medicare & Medicaid Services (CMS). They credit the implementation of more stringent review criteria for measuring claims.

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InfoGard New Testing Body for EHR
The Office of the National Coordinator for Health Information Technology (ONC) has added InfoGard Laboratories, Inc. to its list of ONC-authorized meaningful use EHR testing and certification bodies (ONC-ATCBs). InfoGard Laboratories, Inc. is the third organization to be selected as an ONC-ATCB. The other two ONC-ATCBs are the Certification Commission for Health Information Technology (CCHIT) and Drummond Group, Inc.

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Coding Tips

New Codes, Fees for Flu Shots
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Don't Ask; Check NCCI
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Congrats, Qutenza! You're a Code.
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PET NaF-18 Clarified, Corrected
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AAO Explains It All: 2011 ENT Changes
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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
Senate Passes Bill
VAD Conditions Expand
10% Raise PCPs
New Innovation Center
Docs Report to EHRevent
Rules Slash Improper Pay
InfoGard Testing for EHR
Coding Tips
Test Yourself Online
Coding Job Links

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