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AAPC November 7, 2007
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Issue #88

Top Stories

Nationwide Health Information Network One Step Closer to Reality

Calling All HHAs Interested in Pay For Performance

SGR Fix, SGR Fix, Wherefore Art Thou SGR Fix?

The National Uniform Billing Committee Removes Outdated Revenue Codes

Acute Care Hospitals Get a Raise For Quality Reporting

Looking for Kudos!


Test Yourself - Earn .5 CEUs
Michelle Dick

Michelle Dick
EdgeBlast Editor

Renée  Dustman

Renée Dustman
EdgeBlast Author

Top News

Nationwide Health Information Network One Step Closer to Reality

The U.S. Department of Health and Human Services (HHS) has chosen nine contractors to participate in the Nationwide Health Information Network (NHIN). The nine contractors will collaborate under the NHIN Cooperative to test and demonstrate the exchange of private and secure health information among providers, patients, and other health care entities.

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Calling All HHAs Interested in Pay For Performance

The Centers for Medicare and Medicaid Services (CMS) is looking for home health agencies (HHAs) that are interested in participating in a pay-for-performance demonstration. Your HHA may qualify if it is located in one of the following states:

Northeast region: Connecticut, Massachusetts
Southern region: Alabama, Georgia, Tennessee
Midwestern region: Illinois
Western region: California

CMS is looking for representatives in all seven states to participate in the 2-year demonstration, which is to begin Jan. 1, 2008.

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SGR Fix, SGR Fix, Wherefore Art Thou SGR Fix?

Earlier this year, the Centers for Medicare and Medicaid Services (CMS) announced that unless Congress intervened to change the law, the Medicare Physician Fee Schedule (MPFS) payments would be reduced by 9.9 percent across the board effective Jan. 1, 2008. Members of Congress vowed to enact the legislation necessary to prevent this cut from taking place as projected.

The threat of an across-the-board cut in Medicare payments has loomed for the past several years. These cuts are mandated under a formula approved by Congress several years ago called the Sustainable Growth Rate (SGR) formula. The projected cut for 2008 is the largest threatened cut in recent history.

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The National Uniform Billing Committee Removes Outdated Revenue Codes

The National Uniform Billing Committee (NUBC) has discontinued several revenue codes with a “9-Other” designation. Effective Oct. 1, 2007, providers should no longer use revenue codes 0599, 0709, 0719, 0749, 0759, 0779, 0789, and 0799. As a result, the Centers for Medicare and Medicaid Services (CMS) has removed Medicare revenue codes 0709 and 0719 from the Medicare Claims Processing Manual, Chapter 4, § 20.5.1.1 (Packaged Revenue Codes).

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Acute Care Hospitals Get a Raise for Quality Reporting

Ninety-three percent of the nation’s acute care hospitals that participated in the Reporting Hospital Quality Data for Annual Payment Update (RHQDAPU) program for 2007 met requirements. In return, they will receive a full payment rate increase of 3.3 percent in 2008. The other seven percent that either didn’t meet requirements or didn’t participate will experience a 2 percent reduction (1.3 percent in 2008) in the “market basket update,” as outlined in 5001(a)(2) of the Deficit Reduction Act (DRA).

The market basket update, a fixed-weight index, is a hospital-specific measure of inflation for the costs of inpatient goods and services used for Medicare beneficiaries.

Under the RHQDAPU program for 2007, participating hospitals reported on the quality of care they provided to patients with heart failure, heart disease, pneumonia, and patients having surgery. In 2008, hospitals will be required to report on 27 quality measures.

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Looking for Kudos!

Have you performed your 100th prospective claims audit at your practice? Did you just finish your first marathon? Have you recently filed appeals that brought in an extra $50,000 in revenue for your facility? Wed 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 CEU renewal every two years. Simply answer the questions and list this as one of your itemized CEUs on your CEU form. If you are chosen for verification, we will then ask you to send in a copy of your work.  Please put the number of each EdgeBlast included in your submission. 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 Level II manuals.

1. What is the purpose of the Nationwide Health Information Network?

Answer:

2. What are three of the seven OBQI measures?

Answer:

3. As of Oct. 1, 2007, how many specified conditions present on admission are acute care hospitals participating in the RHQDAPU program required to report on?

Answer:

4. What is the name of the formula that mandates cuts to the Medicare Physician Fee Schedule?

Answer:

5. List the revenue codes the NUBC recently discontinued during the process of developing the UB-40 (CMS-1450).

Answer:

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AAPC Anaheim National Conference

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