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Issue #195 - April 18, 2012


AAPC EdgeBlast

HHS Proposes ICD-10 Delay to Oct. 1, 2014

The nation will switch to the International Classification of Diseases, version 10 (ICD-10) Oct. 1, 2014 rather than the original Oct. 1, 2013 date, according to a proposed rule. Department of Health & Human Services (HHS) Secretary Kathleen Sebelius announced the proposed regulation April 9, which was published in the Federal Register April 17 with a 30-day comment period.

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CMS Updates Physician Fee Schedule

Several new codes with retroactive effective dates highlight the April update to the 2012 Medicare Physician Fee Schedule Database (MPFSDB). The quarterly adjustment, mandated by the Centers for Medicare & Medicaid Services (CMS), means you may want to re-examine claims using some of the retroactively effective codes and contact your Medicare administrative contractor (MAC) for any possible payment adjustments.

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CMS Extends EHR Eligibility Appeals Deadline

Wish you had more time to qualify for the Medicare Electronic Health Record (EHR) Incentive Programs' 2011 payment year? You're in luck.

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New Shared Savings Program Enhances ACOs

Twenty-seven accountable care organizations (ACOs) have signed on to the new Medicare Shared Savings Program (Shared Savings Program) with the Centers for Medicare & Medicaid Services (CMS), taking responsibility for quality of care furnished to Medicare subscribers. If successful, the ACOs will get a piece of the savings realized through better care, CMS said.

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RAC Record Requests Expanded for Facilities

On March 15, recovery audit contractors (RACs) began requesting additional records from hospitals and skilled nursing facilities (SNFs). The new limit requested every 45 days is 2 percent of all claims submitted in the prior year, divided by 8, and subject to specific caps.

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Coding Tips

Carriers Hold Claims for Codes 33249, C1882
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New HCPCS Level II Codes Effective July 1
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New Waived Tests Payable Under Medicare
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Look for NCCI Quarterly Update in May
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2012 DMEPOS Jurisdiction List Updated
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Medical News

Utah Data Breach Escalates to 780,000 Victims
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CMS Posts EHR Stage 2 Proposed CQMs for 2014
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HHS Unveils New, Collaborative Influenza Detection and Response Plan
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HHS and DOJ Turn up the HEAT: Anti-fraud Efforts Net Record Results
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Physician Groups List Unnecessary Tests and Procedures
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Featured Items
Proposed ICD-10 Delay
Physician Fee Schedule
EHR Eligibility Appeals
Shared Savings Program
RAC Record Requests
Coding Tips
Medical News
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