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Issue #200 - July 5, 2012


AAPC EdgeBlast

MACs Perform 4010 Closeout Activities

The July 1 compliance date for the ASC X12 Version 5010 and NCPDP Version D.0 has arrived. To be paid for Medicare fee-for-service (FFS) claims submitted electronically to payers after 5 pm ET on June 29, your practice must have made the transition to these electronic transaction standards.

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Three-day Rule for Related Non-diagnostic Services Is in Effect

Effective July 1, physician offices and other Part B entities wholly owned or operated by a hospital must append modifier PD Diagnostic or related nondiagnostic item or service provided in a wholly owned or operated entity to a patient who is later admitted as an inpatient within 3 days to codes for diagnostic or related non-diagnostic items or services furnished to a Medicare patient who is later admitted as an inpatient within a three-day payment window.

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OCR Releases HIPAA Audit Protocol

The Office for Civil Rights (OCR) released on June 26 a protocol for a Health Insurance Portability and Accountability Act (HIPAA) audit program that is already underway. Mandated by the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, the OCR piloted the program in November 2011 and will continue audits until the end of the year.

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Docs Manually Code E/M with EHRs

Physicians are adopting electronic health record systems (EHRs) quickly, but they aren't letting them do most of the work, according to the U.S. Department of Health & Human Services (HHS) Office of Inspector General (OIG). A recent study, outlined in a June 21 report, found all of those surveyed who have EHRs don't use their systems' automatic coding modules to assign evaluation and management (E/M) codes.

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CMS Surpasses Its Goal: 100,000+ Providers Use EHRs "Meaningfully"

More than 100,000 health care providers are using electronic health records (EHRs) that meet federal standards, the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) announced in a June 19 press release.

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HHS Announces Health Care Innovation Awards

U.S. Department of Health & Human Services (HHS) Secretary Kathleen Sebelius announced June 15, 81 new Health Care Innovation Awards recipients, bringing the total number of awards to 107 in the past two months. The awards will fund diverse projects in all 50 states, as well as in Puerto Rico and the District of Columbia, for the purpose of delivering high-quality medical care, enhancing the health care workforce, and reducing costs. HHS will award up to $900 million for such projects over the next three years.

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Alaska Settles Breach Case for $1.7 million

Alaska's Department of Health & Human Services (DHSS), the state's Medicaid agency, will pay $1.7 million to the U.S. Department of Health & Human Services (HHS) after reporting a USB hard drive containing personal health information (PHI) was stolen from a state employee's car. This is the first fine levied by the Office of Civil Rights (OCR) against a state agency.

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MedPAC Reports on Health Care Delivery System

Medicare Payment Advisory Commission's (MedPAC) June 2012 "Report to the Congress: Medicare and the Health Care Delivery System" has been released. The six-chapter report evaluates Medicare payment issues and makes recommendations to Congress regarding access to care, quality of care, and other issues affecting Medicare.

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Coding Tips

ASCs Begin Quality Reporting in October
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Expect Tighter Controls for Diabetic Supply Claims
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CMS Leaves Bariatric Surgery Coverage Up to MACs
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Medical News

Supreme Court Affirms Affordable Care Act
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14 Million Patients Enjoy Preventive Care in 2012 So Far
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Consumer Reports to Rate PCPs Nationwide
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Clinical Guidelines Updated for Obesity Screening
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AMA Updates Mammography Recommendations
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Website Change for OIG's Compliance Program Guidelines
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New Process for Handling esMD
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Featured Items
4010 Closeout
3-day Rule
HIPAA Audit Protocol
Manually Coding E/M
100k+ Docs Use EHRs
Innovation Awards
$1.7 Million Breach
MedPAC Report
Coding Tips
Medical News
Coding Job Links


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