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Issue #191 - February 15, 2012


AAPC EdgeBlast

CMS: Prepare Now for 5010 Enforcement Beginning April 1

The Centers for Medicare & Medicaid Services (CMS) is reaching out to providers, reminding them of the Version 5010 standard that will be enforced beginning April 1. To get ready, the agency is offering the following tips:

To ensure a smooth upgrade prior to April, you will need to complete both phase I internal and phase II external testing of Version 5010 transactions. As part of your external testing, you will need to conduct tests with outside trading partners, which include vendors, clearinghouses, billing services, and payers. Your vendor is a critical partner in achieving Version 5010 compliance.

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CMS Starts Immediate Recoupment for Overpayments

The Centers for Medicare & Medicaid Services (CMS) is implementing an immediate recoupment process for demanded overpayments. As it stands, Medicare contractors begin recoupment of an overpayment on day 41 from the date of the initial demand letter. Effective July 1, 2012, however, providers can request recoupment to begin prior to day 41. Providers who elect this process may avoid the assessment of interest if the overpayment is paid back in full before day 31.

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Physicians: Exercise Caution When Reassigning Payments

An alert issued Feb. 8 by the Office of Inspector General (OIG) warns physicians of their liability for false claims submitted by entities receiving reassigned Medicare payments.

To hit this point home, the OIG cites in the alert a recent case where eight physicians who reassigned their Medicare benefits to various physical medicine companies violated the Civil Monetary Penalties Law "by causing the submission of false claims to Medicare."

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HHS Commits to More Streamlined, Efficient Regulation

Consistent with Executive Order 13563, which calls for a "streamlined, effective, efficient regulatory framework designed to promote economic growth, innovation, job-creation, and competitiveness," the U.S. Department of Health & Human Services (HHS) has committed to an "ongoing retrospective review" of agency regulations.

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New IVR Tool Puts EHR Incentive Status at Fingertips

Available Feb. 16, providers will be able to obtain information regarding their electronic health record (EHR) incentive through a new interactive voice response (IVR) self-service option via the Centers for Medicare & Medicaid Services' (CMS') EHR Information Center.

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Get Your Health Professional Shortage Area Bonus

If you are a physician who furnishes services to Medicare patients in a primary care geographic health professional shortage area (HPSA) as designated by the Health Resources and Services Administration (HRSA), you are eligible for a 10 percent bonus payment for services provided between Jan. 1, 2012 and Dec. 31, 2012. Psychiatrists who are designated in a geographic mental health HPSA are also eligible for the 10 percent bonus only if their area does NOT already have a geographic primary care HPSA designation.

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Coding Tips

CMS Corrects 2012 HCPCS Level II File
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Medicare Updates Hep B Admin Code Guidance
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Report 58999 for Endometrial Hyperplasia Treatment
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CMS Updates ASP for April
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Avoid Billing Surprises: Know What's Covered in Preventive Visits
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Medical News

MGMA Wants 5010 Relief
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CMS Modifies PMD Demonstration, Sets New Date
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Reform: Payers Must Be Clear
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More Docs Seeking Work at Facilities
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Featured Items
CMS: Prepare for 5010
Overpayments Recouped
Reassigning Payments
HHS: Better Regulations
New IVR Tool
Shortage Area Bonus
Coding Tips
Medical News
Coding Job Links


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