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Issue #173 - May 18, 2011
AAPC EdgeBlast

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Reminder: 5010 Transaction Standard Is on the Way

On April 29, the Centers for Medicare & Medicaid Services (CMS) released Transmittal 2205, offering advice—and a reminder—about the upcoming Accredited Standards Committee (ASC) X12 Version 5010 Health Insurance Portability and Accountability Act (HIPAA) transaction standards for covered entities to exchange HIPAA transactions. The change in standards is required to accommodate the switchover to ICD-10, which will replace ICD-9 on Oct. 1, 2013.

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Final Rule Streamlines Telemedicine Credentialing

A final rule issued by the Centers for Medicare & Medicaid Services (CMS) May 2 simplifies the process hospitals and critical access hospitals (CAHs) can use for credentialing and granting privileges to physicians and other practioners who deliver care through telemedicine. The new regulations are intended to make telemedicine services easier to obtain for beneficiaries, particularly those who live in rural areas.

Prior to the new CMS regulations, practitioners could not provide care via telemedicine unless they were granted practice privileges by both their home hospital and the remote hospital or CAH to which the telemedicine services were being delivered.

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Docs Find Medicare's Physician Compare Info Often Wrong

Could Medicare's Physician Compare website be doing more harm than good? Misinformation and an inadequate search engine have physicians questioning the usefulness of this comparison tool for health care consumers, reports American Medical News.

The American Medical Association (AMA) recently solicited feedback from physicians about the site. According to the amednews May 9 report, "numerous practices from all over the U.S. reported that information was incorrect or missing. Typical errors were name misspellings, the inclusion of physicians who either had retired or died, and incorrect Medicare participation status."

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OIG: 33% of '08 Diagnostic Radiology Claims Lack Documentation

Approximately 33 percent of Medicare claims for diagnostic radiology interpretation and report services submitted in 2008 by hospital outpatient emergency departments (EDs) were paid in error, according to a recent report published by the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG). These claims should not have been paid, the OIG says in the report, because they did not contain sufficient documentation.

In response to the report, the Centers for Medicare & Medicaid Services (CMS) said it will attempt to recoup the erroneous payments from EDs, which add up to nearly $38 million.

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HRSA Offers Grants to Rural Providers Adopting EHR

The Health Resources and Services Administration (HRSA) announced May 5 that it will provide as many as 40 grants totaling $12 million to help rural health care providers achieve meaningful use of electronic health records (EHRs). These grants will be distributed through the Rural Health Information Technology Network Development (RHITND) Program.

EHR "meaningful use" requirements were defined by the Centers for Medicare & Medicaid Services (CMS) in July 2010, in accordance with the American Recovery and Reinvestment Act of 2009 (Recovery Act).

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Coding Tips

July 1: New K Codes for Suction Pumps, Wound Dressings
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HCPCS Level II Drug Codes Updated July 1
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New Policy for Using Modifier KY Effective Oct. 1
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CMS Reaffirms HIV Screening Guidelines
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TOS Error Detected in 2011 HCPCS Level II File
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Medical News

CDC Releases New Guideline for Control of Norovirus
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Free E-prescribing Guide for Practices Updated
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Featured Items
5010 Transaction Standard
Telemedicine Credentialing
Physician Compare
Dx Radiology Claims
HRSA Grants for EHR Use
Coding Tips
Medical News
Coding Job Links


























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