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2012 payment reduction for not e-prescribing?

  1. #1
    Default 2012 payment reduction for not e-prescribing?
    Medical Coding Books
    Have any specialist clinics out there been having trouble meeting the guideline of at least 10 patient encounters that have had an e-prescription sent?
    I work for a General/Vascular surgery practice and I have 5 eligible providers. Most of our prescriptions are for pain meds and that is usually given after surgery not during the office visit. According to one of our surgeons he has not heard anyone talking about this?
    I am the only coder in the practice and I guess I'm just getting a little nervous that no one else seems to be talking about it and we are really struggling to get a claim that meets the criteria in order to submit the G8553.
    If anyone has any suggestions or can share their experience with this, I would greatly appreciate any advice.
    Mary Beth Gord, CPC

  2. #2
    North Carolina
    Actually, I was just speaking about this yesterday. We're experiencing the same issue. I suggested that E Prescribing nsaids (i.e.ibuprofen 500) or antibiodics could be a solution. Obviously, it would have to be medically necessary. I've done some research and there does seem to be a possibilty to E Prescribe narcotics but it appears you have to jump through some hoops first...

    Q.* When can a practitioner start issuing electronic prescriptions for controlled substances?

    A.* A practitioner will be able to issue electronic controlled substance prescriptions only when the electronic prescription or electronic health record (EHR) application the practitioner is using complies with the requirements in the interim final rule.*

    Q. How will a practitioner be able to determine that an application complies with DEA’s rule?

    A.* The application provider must either hire a qualified third party to audit the application or have the application reviewed and certified by an approved certification body.* The auditor or certification body will issue a report that states whether the application complies with DEA’s requirements and whether there are any limitations on its use for controlled substance prescriptions.* (A limited set of prescriptions require information that may need revision of the basic prescription standard before they can be reliably accommodated, such as hospital prescriptions issued to staff members with an identifying suffix.)* The application provider must provide a copy of the report to practitioners who use or are considering use of the electronic prescription application to allow them to determine whether the application is compliant with DEA’s requirements.

    I would love to hear some more thoughts on this...

  3. #3
    There is a list of circumstances exempting providers from this requirement. See if these two apply to your providers:
    - Does not have at least 100 cases during the January-June 2011 period containing an encounter code in the measure denominator; (note the denominator codes do not include 99024 or any inpatient E&M codes)

    - Has less than 10% of their total allowed Part B FFS charges comprised of charges from the eRx measure denominator during the January-June 2011period; (you can run the numbers comparing their surgical allowance to the office E&M allowance and project to the end of June.)
    Jenny Berkshire, CPC, CEMC, CGIC

  4. #4
    North Carolina
    Unfortunatley, this doesn't apply to us... (or fortunately...depending on how you look at it)
    Last edited by RebeccaWoodward*; 04-15-2011 at 09:01 AM.

  5. #5
    We are having the EXACT same issue-right now the only thing that MAY save us is our vascular surgeoun does EVLT's and stab phlebectomies in the office and prescribes meds at the office visit prior to these services dates

    One of surgeouns does not have over 100 medicare patients/cases-does this make him exempt from this?

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