Electronic Health Records in the Practice Setting: From concept to successful implementation

The MOASC Electronic Medical Records meeting was a resounding success. We encourage you to download and review the presentation materials from our presenter Rosemarie Nelson, M.S. of the MGMA.

Special Offer: ChartScape is offering a 25% System discount for MOASC members which is good through end of March. Contact the MOASC office for further details.

ION Meetings For Physicians Only

September 15 - 17 - GI/Lung Symposium - Westin Copley Place, Boston, MA
October 13 - 15 - National/Business Meeting - Gaylord Texan, Dallas, TX

MOASC NHIC Meeting 2/21/06

February 21, 2006 MOASC office met with the NHIC Medical Director and his associates in Los Angeles. Here are some of the answers to the agenda that was submitted:

 

 

Denials of 90767 when billed with 96413. 

 

NHIC has again stated that their were edit problems with this code, but as of 1-24-06 this problem has been corrected. You need to call provider relations, state that you wish to "RE-OPEN THE CLAIM DUE TO AN INTERNAL EDIT PROBLEM" and the problem can be corrected over the phone.   

California Updates

• A new Educational article has been added: Coding Guidelines When Infused Drugs are not on Fee Schedule.
• The March 2006 edition of the Medicare B Resource is now available.
• An Ask the Contractor Teleconference (ACT) on the Advanced Beneficiary Notice is being held March 17.

February 23, 2006

• Effective March 6, 2006 the Provider Telephone Inquiries lines to reach a Customer Service Representative (CSR) will be open from 8:00 AM to 4:00 PM. This change is a result of The Deficit Reduction Act (DRA) of 2006 and instructions contained in a Joint Signature Memorandum from CMS.
• Physicians, providers, and suppliers must enroll in the Medicare program in order to receive Medicare payment for services provided to its beneficiaries. This article contains helpful information about the Medicare enrollment process. (SE0612)
• CMS revised the Additional Information section of the Medicare Remit Easy Print (MREP) Software article in order to refer providers to Medicare's EDI Helpline numbers if more information is needed. (SE0611)
• CMS has again revised the article on the 2006 quarterly average sales price (ASP) Medicare Part B drug pricing file, effective January 1, 2006. (CR 4140)

February 16, 2006

• The Centers for Medicare & Medicaid Services (CMS) is offering a second participation enrollment period for 2006 for physicians. (CR 4346)
• This article states that Congress has amended the physician update from a negative 4.4 percent (-4.4%) update to a zero-percent (0%) update for services provided on or after January 1, 2006, and paid under the MPFS. (CR 4313)
• Beginning in April 2006, Medicare physicians will be given the opportunity to elect to participate in the Competitive Acquisition Program (CAP) for claims paid on or after July 1, 2006. (CR 4064)
• Effective January 1, 2006, Medicare carriers, DMERCs, FIs, and RHHIs will not pay paper claims prior to the 29th day after receipt of the claim. (CR 4284)
• This article informs affected providers of the new web address for SNF consolidated billing information . The new address corresponds to the new web site from the Centers for Medicare & Medicaid Services (CMS), and this new address is also being placed in the Medicare Claims Processing Manual. (CR 4297)
• This CMS article is about the Medicare Remit Easy Print (MREP) enhancements, and clarification of check issue/Electronic Funds Transfer (EFT) effective date. (CR 4289)
• A brief hold will be placed on Medicare payments for all claims for the last nine days of the Federal fiscal year, i.e., September 22, 2006 - September 30, 2006. Claims held as a result of this one-time policy will be paid on October 2, 2006. No interest or late penalty will be paid to an entity or individual for any delay in a payment by reason of this one-time hold on payments. (CR 4349)
• This Special Edition article provides an overview of the new Medicare Remit Easy Print (MREP) software , which is now available for you to view and print the Health Insurance Portability and Accountability Act (HIPAA) compliant Electronic Remittance Advice (ERA). (SE0611)
• This article provides additional requirements for the CAP for Part B drugs and biologicals. (CR 4309)
• This article has been revised: CMS will no longer accept the Surrogate UPIN OTH000 to identify the ordering or referring physicians on claims submitted by billers, suppliers, physicians, and non-physician practitioners, effective for dates of service April 1, 2006, and later. (CR 4177)
• Guidelines for payment of vaccine (Pneumococcal Pneumonia Virus, Influenza Virus, and Hepatitis B Virus) administration (CR 4240).

February 14, 2006

• As a result of the Deficit Reduction Act, and the revision to the 2006 physician update, CMS is offering a second enrollment period for physicians to reconsider their decisions in light of the revised 0 percent update. The second enrollment period will run for 45 days and will begin on February 15, 2006. Any revisions to the Participation election during this new enrollment period will be retroactive to January 1, 2006. (CR 4346)
• On Feb. 8 President Bush signed into law the Deficit Reduction Act of 2005 (DRA). Claims processing using the revised payment rates will begin immediately. The revised Fee Schedules for California and New England have been posted to the website.
• CMS has posted an article on shared systems Medicare Secondary Payer (MSP) balancing edit and Administrative Simplification Compliance Act (ASCA) enforcement update. (CR 4261)
• The quarterly update to Correct Coding Initiative (CCI) edits, Version 12.1, will be effective April 1, 2006. (CR 4308)
• This article provides information on the updates to the lists of HCPCS codes that are subject to the Consolidated Billing (CB) provision of the SNF Prospective Payment System (PPS). (CR 4298)
• CMS has revised the article on Medicare Prescription Drug Coverage: Essential Information and Resources for Prescribing Health Care Professionals – the eleventh in the Medlearn Matters series on the new prescription drug plans. (SE0603)
• Revision to Chapter 31 – Attestation Form for Conducting Real Time Eligibility Inquiries with Medicare (CR 4093 Rev)

February 2, 2006

• This article informs Medicare contractors how to obtain the most recent Healthcare Provider Taxonomy Codes (HPTC) and  to use it to update their internal HPTC tables. (CR 4254)
• This CMS article provides a high-level overview of the software systems Medicare uses to process your claims. Frequently, Medlearn Matters articles reference Medicare systems and this article will help explain briefly the systems. (SE0605)
• The Centers for Medicare & Medicaid Services (CMS) issued revised instructions on the Physician Voluntary Reporting Program on December 23, 2005. These instructions (Pub 100-19, transmittal 35) may be viewed on the CMS website at the following link: http://www.cms.hhs.gov/Transmittals/Downloads/R35DEMO.pdf. A revised Medlearn Matters article (MM 4183) titled "Physician Voluntary Reporting Program (PVRP) Using Quality G-Codes" is also available on the website at http://www.cms.hhs.gov/MedlearnMattersArticles/downloads/MM4183.pdf. (CR 4183 Rev & Message 200601-10)
• The National Provider Identifier (NPI) Final Rule requires health care providers who are organizations and who are covered entities under HIPAA to determine if they have "subparts" that should be assigned NPIs. The NPI Final Rule provides guidance to those health care providers in making those determinations. The Centers for Medicare and Medicaid Services (CMS) has communicated to the Provider Enrollment staff at the carriers and fiscal intermediaries the Medicare program's expectations concerning the determination of subparts for NPI assignment purposes. CMS has posted a document describing the subpart concept and its relationship to the way in which Medicare enrolls its organization providers at  http://www.cms.hhs.gov/NationalProvIdentStand/06_implementation.asp#TopOfPage. This document will be helpful to providers in understanding the issue of subparts and how subpart determination could be done in a way that helps to promote smoother and more efficient Medicare claims processing during the implementation of the NPI in the Medicare program. The health care industry in general has expressed an interest in being informed of this type of information. CMS is making this information available on the CMS website so that it is easily available to interested parties. (Message 200601-11)

CMS Publishes a Part B vs Part D Reference Guide

CMS has identified confusion regarding drugs that are covered under Part B but filled by retail pharmacies and has published a reference guide to clarify coverage for Part B versus Part D drugs. CMS also has recommended that prescriptions written by hematologists/oncologists for certain drugs include the diagnosis, the indication, and whether the coverage is Part B or Part D. 

Core Assumption on Part D vs. Part B

The purpose of this update is to provide general guidance and a brief overview of the core assumptions guiding Medicare Part B and Part D drug coverage determinations.  The content of this update relies on many sources including the Medicare Prescription Drug Benefit Final Rule, CMS policy memoranda, and CMS’ Open Door Forum.  The following information is provided by The Lash  Group.

Journal of Oncology Practice, Letter to the Editor

Dr. Felman, MOASC Board member, has published a Letter to the Editor titled: Pharmacoeconomic Research: The Price of Success in the January 2006 Journal of Oncology Practice.

ASCO/AOHA Support Services Study