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AAPC June 20, 2007
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Issue #79

Top Stories

Are You Adequately Immunized?

Reduce Certification Exam Anxiety

How High Risk Medication Management Can Affect MDM

CMS Offers Open Door Forum on Medicare Enrollment

CMS Revises PQRI Specs

New Study Reveals the "Real" Cost of Offshoring

Looking for Kudos!


Test Yourself - Earn .5 CEUs

UB-92 Use Ended May 22

The UB-92 will not be accepted by CMS after May 22, 2007.
The National Uniform Billing Committee (NUBC) is replacing the UB-92 with the UB-04 paper form. The Health Insurance Portability and Accountability Act (HIPAA), requires submission of National Provider Identifiers (NPIs) on claims effective May 23, 2007, and the UB-92 does not have a field for reporting NPIs. During the period March 1, 2007 through May 22, 2007, providers that use paper forms for claim submission will be able to submit either the UB-92 or the UB-04 form.
More information about the transition is available from the NUBC Web site (http://www.nubc.org/). The UB-04 will retain the CMS-1450 designation.


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Torrey Kim

Torrey Kim, CPC
EdgeBlast editor

Top News

Are You Adequately Immunized?
By Constance Valdez, CPC, CCP, RMC

Vaccines are not just for kids — adults also need to stay current with immunizations to maintain good health. If we take away the protection of vaccination, we could open the door to more people becoming infected and spreading diseases to others, thus undoing all the progress we have made over the years. In other words, we vaccinate to protect the future.

The Centers for Disease Control and Prevention (CDC) reports that all adults should get shots for tetanus and diphtheria (Td) every ten years. The CDC changes this recommendation to every five years when an injury such as a laceration occurs. For this service, you'll report 90714 for the preservative-free vaccine, and 90718 for the standard Td vaccine. In addition, don't forget your administration code(s) from the 90471-90472 range.

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Reduce Certification Exam Anxiety
By Cindy Harms, M.Ed., CPC, CPC-H

How do you get ready academically and psychologically for the certification exam?

Decide which test is for you. If you want to be a facility/outpatient hospital coder, then the CPC-H is your test. Is your goal to be a physician or mid-level provider-based coder? Then the CPC certification exam is best. Would you prefer to work within the payer environment? Then prepare for the CPC-P exam.

Streamline your testing skills. Make sure you give yourself enough time to complete the test. Remember a blank answer is the same as a wrong answer. Answer all the questions you can quickly and go back to those that you struggle with. Try not to spend too much time on any one question.

Understand how to approach and analyze the type of questions on the test. These exams are mostly multiple choice with a few true/false questions. With the multiple choice question, you will need to apply your knowledge to scenarios you have not read before. Straight memorization of facts may not be enough. You cannot just be familiar with the material — you must be able to analyze it.

Memory experts say that distributive learning, or studying that is spread over a long period of time, is better than cramming right before the test. Regularly organize your notes. Work on "thinking like a coder." Keeping up with reading assignments will reduce pressure as the exam date gets closer.

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How High Risk Medication Management Can Affect Medical Decision-Making
By Pam Brooks, CPC

One factor that affects the level of medical decision-making (MDM) within an E/M visit is the management of "high risk" medications. This phrase is misleading because according to current auditing guidelines, the criteria that must be met is the documentation of "drug therapy requiring intensive monitoring for toxicity." In actuality, this management option isn't only about the type of drug, but could refer to the frequency and vigilance of monitoring that is required to ensure therapeutic levels, avoid drug interaction and ultimately support patient safety. The key word here is "intensive."

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CMS Offers Open Door Forum on Medicare Enrollment

CMS announced today that it will hold a special open door forum (ODF) on June 29 at 2:00 pm Eastern time to discuss tips that can help facilitate Medicare enrollment.

As part of the ODF, CMS officials will share information about the 2006 Medicare enrollment applications, and will provide useful tips on how providers can enroll in the Medicare program. Following the CMS discussion, Medicare staff will take comments about the Medicare enrollment process.

Anyone interested in participating in the ODF should register by June 27 at 2:00 pm (eastern time) at http://registration.intercall.com/go/cms2.

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CMS Revises PQRI Specs

Earlier today, CMS announced revisions to the final 2007 PQRI Measure Specifications. This version (1.1) will incorporate technical corrections that were made to the previous versions. Coding professionals interested in reading the revisions should visit the “measures/codes” section of CMS’ PQRI website at www.cms.hhs.gov/pqri.

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New Study Reveals the "Real" Cost of Offshoring

Coding professionals are well aware of the recent trend of outsourcing business offshore so employers can potentially save money. But a recent Business Week article suggests that "shifting production overseas has inflicted worse damage on the U.S. economy than the numbers show." Although analysts initially believed that offshoring was not negatively impacting the economy, the new statistics show that a problem does indeed exist. To read the full text of the article, visit the link below.

Business Week Article

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Looking for Kudos!

Have you recently filed appeals that brought in an extra $1 million in revenue for your facility? Have you spoken at your state medical society? Did you run the Marine Corps Marathon? We’d love to hear about it! Please submit your Kudos to our editors at kudos@aapc.com.

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Test Yourself - Earn .5 CEUs

By answering the following questions, you can earn .5 continuing education units to apply toward your annual AAPC certification renewal. Simply answer the questions and send in a copy of your work when submitting your CEU package or enter your CEUs into the CEU Tracker online. Include the number of each EdgeBlast on your submission (example: #79). The number is available at the top of the page.

Answers to the questions are not always found directly (word for word) in the EdgeBlast in which they appear. While often related to the EdgeBlast content, they require additional resources such as your ICD-9-CM, CPT® and HCPCS manuals.

1. Code 90732 corresponds to what type of immunization?

Answer:

2. Is Coumadin® usually considered a high-risk medication?

Answer:

3. How many questions are on the AAPC's certification exams?

Answer:

4. The CDC recommends that adults older than 50, pregnant women, health care workers and residents of long-term care facilities get what type of immunization every autumn?

Answer:

5. What should a coder do if they are struggling to answer a particular question on the certification exam?

Answer:

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