The Centers for Medicare and Medicaid Services made it easier this year to collect a bonus for Electronic Prescribing. For certain ambulatory services, CMS now requires only one “G” measure code to be submitted on a claim. The measure is required to be reported on only 25 claims for the reporting period to be eligible for the 2% bonus. This is much easier than last year, when CMS required that one of three measure codes be submitted on 50% of eligible claims.

The micro lab has numerous “add on” procedures that are routinely performed to complete the culture report. Frequently, add on charges are never captured. There are several reasons for this – some process driven (such as bill drop dates coming too soon for the completion of all testing) and human errors (not submitting charges in a timely manner). One BIG reason is simply because bacteria do not grow at the whim of human time lines.

The Office of Inspector General (OIG) found that public disclosure of information about adverse events was limited, according to its review of 17 state adverse event report systems, eight Patient Safety Organizations overseen by the Agency for Healthcare Research and Quality (AHRQ), and the Centers for Medicare and Medicaid Services (CMS).

A Department Appeals Board (DAB) order upholding the finding of an immediate jeopardy level violation and the imposition of $3,500 per day civil money penalty (CMP) against a skilled nursing facility (SNF) was vacated by the Eighth Circuit Court of Appeals because the DAB's finding was based on pure

CMS issues its changes to the Physician Fee Schedule quarterly, but how often do you have the chance to analyze it and review it? With over 15000 lines filling a spreadsheet, comparing each quarter’s changes can be a daunting and time consuming task. Are you aware that MediRegs does this for you? They issue a difference report every quarter that highlights the changes between the current version and the last quarter’s version. Look for the file called “Difference Report” and “MediRegs created.”

A conversation was recently had with a CMS representative regarding their policy and billing instructions associated with observation hours and services in situations when a patient is admitted as an inpatient but is subsequently found to be only eligible for observation; thus billed as an outpatient on the UB-04 reporting the Condition code 44.

Coding professionals face increasing challenges to code claims accurately. Facilities can help ensure documentation integrity and coding accuracy by establishing and managing an effective query process. The importance of complete documentation in the patient’s health record cannot be overstated; without such documentation accurate coding cannot be assigned.

CMS has revised or better defined several current policies for the supervision of outpatient services. The goal, per CMS, is “to ensure that hospital outpatient services are appropriately supervised by qualified practitioners while not impeding beneficiary access to these services, and in response to concerns raised by the hospital community.” In 2010, CMS will allow certain non-physician practitioners (NPP) (specifically physician assistants, nurse practitioners, clinical nurse specialists, certified nurse midwives, and licensed social workers) to provide direct super

MediRegs, a part of Wolters Kluwer Law & Business (mediregs.com), is pleased to announce that MediRegs ComplyTrack® Suite has been selected as a finalist in the 25 th annual Software & Information Industry Association CODiE Awards. The awards recognize excellence and innovation in information and software products and applications.

While attending the AMA Symposium this week there was a HUGE uproar about eliminating payments for consults.  I thought one physician was going to take the head off of the guy from CMS!  Whoa baby, talk about hot!  Then you have the coders who are gunning for bear.  The AMA left the CPT consult codes in for 2010 but CMS says they won’t pay!  In light of this, the attending physicians are going to have to bill the initial hospital care day with a modifier.  Then the consultants come along and they have to use the