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December 27, 2011

Article: CMS Will Not Provide Interim Feedback Reports for Determining if Individual Providers will Incur the 1% 2012 ERx Penalty for Medicare Part B Fee Schedule Services
   Despite CMS indicating in their 9/6/11 final E-Prescribe rules that providers would receive an interim feedback report to know in advance if they would receive the 1% ERx penalty adjustment as of 1/1/2012, CMS announced 12/20/11 these reports were not "technically feasible" for them to provide.
   In addition, CMS has NOT processed the ERx exemption requests which providers could apply for using the Communication Support Page up until 11/8/11. CMS indicates the volume of these requests was too great. The ONLY email notices thus far sent to providers as a result of their exemption request filings, were sent to providers from QualityNet on 12/9/11. The email notified providers they would not be penalized as of 1/1/2012; BUT WAS NOT due to the actual exemption request reason the provider filed. The email was sent to providers whose actual data had been reviewed for the period 1/1/11 thru 6/30/11 based on the Name/NPI/TIN listed in the exemption request; and determined they were already exempt from the penalty (no filing of an exemption request was required). The email sent to providers was VERY confusing. Here is what the email said:
   "Thank you for submitting a request for a significant hardship exemption from the 2012 electronic prescribing (eRx) payment adjustment. Our records indicate that you submitted one or more requests for a significant hardship exemption to the 2012 eRx payment adjustment. This formal notification is to inform you that the 2012 eRx payment adjustment, which will result in a 1.0 percent reduction on an eligible professional’s 2012 Medicare Part B physician fee schedule covered professional services, does NOT apply to you based on the identifying information received in your hardship request. Therefore, your request(s) for a significant hardship exemption to the 2012 eRx payment adjustment will be disregarded.
   If you received the above email...GREAT!! If you did not, then you will NOT receive any notification as to your penalty status that kicks in as of 1/1/2012, although CMS says they contunue to work on a method for notifying providers. At this late date, do not hold your breath.
   Instead, your first indication as to receiving the 1% penalty will occur when you start receiving your 2012 Medicare remittances. On 12/21/11, CMS posted an article describing the remittance and remark codes that will indicate the 1% penalty has been applied. To read the Medlearn article, click here.
   If the exemption request you filed on the Communication Support Page is ultimately approved by CMS after 1/1/2012, any claims where the penalty applied would then need to be re-processed thus creating further chaos to your patient account reconciliation. The MedLearn article also describes the remittance and remark codes you will see when the ERx penalty is subsequently adjusted.

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Collection Formulas PDF Collection Formulas for Assessing the Health of Your A/R - Free Download

CPT 2008 Telephone Codes for Physicians & Non-Physician Practitioners PDF CPT 2008 has deleted the old telephone codes and added new codes for Physicians and a separate category for Non-Physician Practitioners. Download the document to review the codes and the rules.

2008 CPT Smoking & Tobacco Use Cessation Counseling Codes PDF CPT 2008 adds new codes for Smoking & Tobacco Use Cessation Counseling. Medicare has provided a payable benefit for this service since 2005 using the now deleted "G" codes. Medicare's benefit will continue with the use of the new CPT codes. Download this document for the codes and rules. Don't miss out on potential new revenue for your practice.

CPT 2008 Online Evaluation Codes for Physician & Non-Physician Practitioners PDF CPT 2008 added new codes for online evaluations. Medicare does not provide a payable benefit; but the codes are considered "non-covered". View the rules in this document to see when there may be a potential billing opportunity for Medicare and Non-Medicare patients.

New ABN PDF New Advance Beneficiary Notice (ABN) implemented 3-3-08 & Mandated for Use 3-1-09.

CMS Quick Reference Chart of All Preventive Services PDF It is hard to keep up with all the details of ALL Medicare preventive and screening services. This CMS chart (updated for 2009) is very helpful.

2009 Crosswalk Chart for Cardio Implanted Device Interrogation & Programming PDF CPT 2009 dramatically changed the landscape for coding interrogation & evaluation of implanted cardiac devices. Many 2008 codes are deleted with lots of new codes that have 30 and 90 day global periods. This crosswalk chart may help your understanding.

Overview & Coding Examples for 2011 Cardiac Cath Coding PDF Dramatic changes occurred in CPT 2011 for cardiac catheterization coding. Download this document to understand the changes. Included are many coding examples for 2010 coding vs 2011.

Overview of 2011 Endovascular Revascularization Coding PDF Coding for Endovascular Revascularization (aka Peripheral Extremity Interventions) has changed dramatically in 2011. Download this document for the new codes and instructions including an anatomical picture of the lower extremity arterial system.

New Medicare Annual Wellness Visit (AWV) Effective 1/1/2011 PDF As of 1/1/2011 Medicare now offers a payable Annual Wellness Visit. Download this document for details & requirements for billing this new service.

Avoiding E-Prescribe Penalties for 2012 & 2013 PDF Avoiding penalties for not successfully E-Prescribing in the Medicare program depends on what you do (or don't do) in 2011. Many practices are confused about the requirements for avoiding the penalties. Download this document to understand what the requirements are!