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Issue #181 - September 21, 2011
AAPC EdgeBlast

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OIG Tells CMS: Audit POS 11 Claims

If you're doing outpatient surgery in a facility, make sure you're reporting the right place-of-service (POS) code. After finding 83 percent of a sample of POS 11 claims miscoded and overpaid in 2009, the Office of the Inspector General (OIG) recommended several actions to the Centers for Medicare & Medicaid Services (CMS) in a Sept. 7 report. These include audits and recovery.

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2011 eRx Incentive Final Rule Posted

The Electronic Prescribing (eRx) Incentive Program 2011 final rule has been posted by the Centers for Medicare & Medicaid Services (CMS). The rule fulfills requirements laid out in the Medicare Improvements for Patients and Providers Act (MIPPA) by defining what a provider must do to avoid the Medicare Physician Fee Schedule (MPFS) adjustment should he or she not adopt eRx. New "Significant Hardship" exemptions are intended to help physicians who are unable to adopt the program.

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Rule May Grant Patients Access to Lab Test Results

A proposed rule, drafted jointly by the Centers for Medicare & Medicaid Services (CMS), the Office for Civil Rights (OCR), and the Centers for Disease Control and Prevention (CDC), would amend a patient privacy provision of two federal laws to grant patients access to test results directly from laboratories through the use of health information technology (health IT).

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Use Revised ABN by Nov. 1

Providers (including independent laboratories), physicians, practitioners, and suppliers now have until Nov. 1 to begin using the revised Advanced Beneficiary Notice of Noncoverage (ABN) Form CMS-R-131.

The original implementation date was Sept. 1 but the Centers for Medicare & Medicaid Services (CMS) extended the mandatory use date to Nov. 1 to give providers and suppliers more time to transition to using the new form, and to use up stockpiles they may have of old forms.

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Providers Rate Medicare Contractors' Overall Performance

The results of the sixth annual Medicare Contractor Provider Satisfaction Survey (MCPSS) indicate an overall satisfaction level providers have with their Medicare contractors' performance, with nearly 73 percent stating they are either satisfied (54.48 percent) or very satisfied (18.02 percent). The survey, conducted by the Centers for Medicare & Medicaid Services (CMS), had a good response rate, as well. Out of the 30,000 Medicare fee-for-service (FFS) providers and suppliers across the country who were asked to participate in the survey, over 16,000 responded.

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California Billing Company Ponies Up $4.6M to Settle False Claims Allegations

California-based medical billing company Janzen, Johnston & Rockwell Emergency Medicine Management Services Inc. (JJ&R) has agreed to pay $4.6 million to settle allegations that it submitted false claims to Medicare and Louisiana's Medicaid program, according to the Department of Justice (DOJ).

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Providers See Payoff for EHR Meaningful Use

A recent report from the Centers for Medicare & Medicaid Services (CMS) confirms that the total of payments to providers participating in the Medicare Electronic Health Record (EHR) Incentive Program hit the $149 million mark as of July 31.

Providers are taking advantage of early EHR implementation incentives. If your practice hasn't jumped on board the EHR bandwagon yet, it's not too late.

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Coding Tips

New Codes, Payment Corrections, and More in Oct. Updates
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SNFs, Be Ready for Oct. HCPCS Level II Update
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MAC's Tips for Getting Radiology Services Paid
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OIG J9 Audit Finds $1.7M in Overpayments
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CMS: Who Can Contact You About What?
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J1 MAC: Hemorrhoid Artery Ligation Covered When All Else Fails
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Medical News

Counterfeit Mesh Distributors Liable for Post-op Complications
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CDC Consulted on the Making of "Contagion"
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Medicare Pilots Project for esMD
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Journal: EHR Improves Diabetes Care
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Health Care Adds Jobs in Down Economy
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Coding Job Links

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Featured Items
OIG: Audit POS 11 Claims
eRx Incentive Final Rule
Access to Lab Results
Use Revised ABN by Nov 1
Satisfaction w/ Contractors
False Claims Cost $4.6M
EHR Incentive Pays Off
Coding Tips
Medical News
Coding Job Links


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