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TAOG Executive Office Karen O'Briant 141 Idlewild Creek Road Sweetwater, Texas 79556 (325) 235-1959 FAX: (325) 235-4687 TOLL FREE (866) 935-1959 TAOG 
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| May 2008/Vol 8, Issue 5 |
You are here: Practice Issues > May 2008/Vol 8, Issue 5
Practice Management and Coding Update
American College of Obstetricians and Gynecologists (ACOG)
May 2008/Vol 8, Issue 5
Welcome to ACOG's Practice Management and Coding Update. The Update provides timely information on coding, reimbursement and practice management issues. Information on a variety of coding and practice management issues is available on ACOG's web site under the Practice Management heading at http://www.acog.org/.
In this issue of the Update:
1) CCI UPDATE AVAILABLE FOR MEMBERS
2) SIGN UP FOR DRUG ALERTS - HEALTH CARE NOTIFICATION NETWORK (HCNN)
3) EMR VENDOR CHALLENGE SCHEDULE AT ACOG ANNUAL CLINICAL MEETING
4) DO YOU NEED AN ELECTRONIC MEDICAL RECORDS SYSTEM?
5) CMS FINAL E-PRESCRIBING REGS - EFFECTIVE APRIL 2009
6) AMA ANTITRUST EDUCATIONAL RESOURCE
7) CMS ONLINE MANUAL SYSTEM
8) NPI REQUIRED ON ALL STANDARD TRANSACTION ON MAY 23
9) CMS PQRI ALTERNATE REPORTING OPTIONS
10) BLUE CROSS BLUE SHIELD ASSOCIATION SETTLEMENT
11) ACOG LIVE WEBCASTS:
MAY 13, 2008: Coding with Modifiers
JUNE 10, 2008: PAY FOR CALL
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1) CCI UPDATE AVAILABLE FOR MEMBERS
Correct Coding Initiative (CCI) edits effective April 1 are available on the ACOG website for members. The CCI lists pairs of CPT codes or "edits" that Medicare considers bundled. These edits are updated quarterly. ACOG members may access this information from the Coding and Nomenclature page at: http://www.acog.org/departments/dept_notice.cfm?recno=6&bulletin=1127&membersOnly=TRUE
2) SIGN UP FOR DRUG ALERTS - HEALTH CARE NOTIFICATION NETWORK (HCNN)
HCNN is a new, free online service that delivers drug alerts mandated by the FDA to registered providers via email. Currently, these safety alerts are sent on paper (Dear Doctor letters) through the US Postal Service. With HCNN, emails will be sent immediately to registered providers whenever a new safety alert is generated. The HCNN will also be used to notify physicians in the event of national public health emergencies or bioterrorism alerts. All providers should consider registering for this service, whether using an EMR or paper records. For more information and to register with HCNN, go to: http://www.hcnn.net/
3) EMR VENDOR CHALLENGE SCHEDULE AT ACOG ANNUAL CLINICAL MEETING
ACOG's Committee on Ambulatory Practice Operations is sponsoring an EMR "Vendor Challenge" from 9:00 am to 4:00 pm on Sunday, May 4th at ACOG’s Annual Clinical Meeting (ACM) in New Orleans Morial Convention Center, Rooms 346 -347. Vendors will have 30 minutes to show how their EMR product deals with specific patient situations based on ob and gyn scenarios. ACOG does not recommend any particular EMR product and is pleased to offer this opportunity for physicians to preview several different vendors. All vendors who participate in the Challenge will be available on the Exhibit floor during the ACM as will other vendors who are not participating in the Challenge. The Challenge schedule is available at:
http://www.acog.org/departments/dept_notice.cfm?recno=47&bulletin=4450
4) DO YOU NEED AN ELECTRONIC MEDICAL RECORDS SYSTEM?
Have you asked yourself this question lately? Everyone by now has at least heard the rhetoric (good and bad) about electronic medical records systems (EMRs) for physician offices. ACOG Fellow, Michael McCoy, MD discusses this issue along with office readiness and other considerations.
http://www.acog.org/departments/dept_notice.cfm?recno=19&bulletin=4538
5) CMS FINAL E-PRESCRIBING REGS - EFFECTIVE APRIL 2009
The final e-prescribing regulations for Medicare Part D have been published and will take effect April 2009. The regulations will govern how physicians, pharmacies and drug plans communicate electronically to handle drug orders. These regulations do NOT mandate the use of e-prescribing, but practices that do prescribe electronically must be compliant with the rules by April 2009. The regulations have four categories: formulary and benefits, medication history, fill status notification, and provider identifiers.
For information see the CMS April 2 Press Release or http://www.cms.hhs.gov/EPrescribing/
Many EMR users are unaware that they are generating faxes that arrive on paper at the pharmacy’s fax machine. These computer-generated, faxed prescriptions will not be in compliance with the new regulations. ACOG is collaborating with MGMA, and other medical specialty societies to assist practices with e-prescribing. For more information go to:
http://www.acog.org/departments/dept_notice.cfm?recno=19&bulletin=4540
6) AMA ANTITRUST EDUCATIONAL RESOURCE
The AMA’s Private Sector Advocacy office has developed an antitrust educational resource: Competing in the marketplace: How physicians can improve quality and increase their value in the health care market through medical practice integration. The document provides guidance to physicians on mergers and financial and clinical collaborative arrangements based on options approved by the federal agencies who enforce the antitrust laws. This resource is available on the AMA website: http://www.ama-assn.org/ama/pub/category/9880.html
7) CMS ONLINE MANUAL SYSTEM
CMS has updated the brochure detailing the CMS Online Manual System. The brochure explains the organization of the six subsections of the Online Manual System and how to navigate each subsection. To download the brochure, go to: http://www.cms.hhs.gov/MLNProducts/downloads/on-linebrochure.pdf
To access the CMS Manuals, go to: http://www.cms.hhs.gov/Manuals/
8) NPI REQUIRED ON ALL STANDARD TRANSACTION ON MAY 23
Beginning May 23, only the NPI may be reported on Medicare claims. Claims will be rejected if legacy numbers are reported in addition to the NPI. CMS urges you to check with your clearing house or billing service to ensure that they have successfully tested and are submitting claims with the NPI only.
The NPI must also be reported for any referring provider.
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5890.pdf
NPIs can be looked up on the NPI Registry at: https://nppes.cms.hhs.gov/NPPES/NPIRegistryHome.do
CMS encourages all providers to check with other third party payers to ensure you are in compliance with their expectations for the May 23 implementation deadline.
9) CMS PQRI ALTERNATE REPORTING OPTIONS
CMS is offering a variety of new reporting options to make it easier for eligible professionals to participate in the PQRI program. Beginning July 1, 2008 practices may choose to report on any of four PQRI group measures: diabetes, end-stage renal disease, chronic kidney disease or preventive care. Group measures consist of individual measures and must be reported 80% of the time between July 1 and December 31. CMS is also establishing a reporting process through clinical registries. A final list of approved registries will be available by August 31.
Because Medicare patients usually comprise a small percentage (usually no more than 5%) of an ob-gyn’s patients, few obstetrician-gynecologists are participating in this incentive program. If you are interested in more information in the PQRI program, go to: http://www.cms.hhs.gov/PQRI/
10) BLUE CROSS BLUE SHIELD ASSOCIATION SETTLEMENT
The final order in the Blue Cross Blue Shield Association settlement was filed on April 21 in Miami. The settlement is designed to implement business practice changes along with a cash settlement payment of $128 million to class members. BCBSA mailed claim forms to physicians in July 2007. The deadline for filing a claim was October 19, 2007.
Under the settlement, business practices, such as “gag” clauses and “all products” clauses are prohibited from physician contracts. Also, automatic down-coding is prohibited and compliance with CPT guidelines with certain exceptions is required.
For more information on the settlement, including state specific information, go to:
http://www.ama-assn.org/ama/pub/category/18037.html
The settlement documents are available from http://www.hmosettlements.com
11) ACOG LIVE WEBCASTS:
May 13, 2008: Coding with Modifiers
1:00 PM – 2:30 PM ET
Presenter: Emily Hill, PA
Cost: $49 Members; $59 Non-members
Registration closes at noon ET on Monday, May 12
This webcast discusses the proper use of CPT-4 modifiers and their impact on reimbursement. It reviews the recent clarifications and revised definitions to select CPT-4 modifiers. Particular emphasis is placed on the differences between modifiers 51 and 59. Clinical scenarios illustrating the proper use of modifiers are used to enhance the understanding of modifier usage in an ob/gyn practice.
For more information and to register, go to: http://www.acog.org/postgrad/pgpage.cfm?recno=453
JUNE 10, 2008: PAY FOR CALL
1:00 – 2:30 PM ET
Presenter: L. Michael Fleischman
Cost: $49 Members; $59 Non-members
Registration closes at noon ET on Monday, June 9
At the conclusion of this webcast, participants will be able to:
Identify the factors affecting physicians growing reluctance to provide on-call coverage.
Examine strategies hospitals use to provide on-call coverage.
Discuss the connection between pay for call and the anti-kickback and Stark laws.
Understand the limitations associated with compensation for on-call coverage.
Identify alternatives to direct pay for on-call coverage utilizing community resources.
For more information and to register, go to:
http://www.acog.org/postgrad/pgpage.cfm?recno=466
Archives of previous ACOG webcasts are available at: https://www.wgitv.com/ppv/course/main.asp?AgencyID=689
Physicians, practice administrators and staff will find ACOG Webcasts of interest. Participants need a computer with speakers and Internet capability. Your registration fee covers one Internet connection from each site, but you may have an unlimited number of participants on your connection. Each Webcast is approved for AMA Category 1 type credits. See the specific webcast information for CME credit information. For questions about webcasts, please contact Anne Diamond at 202-863-2444 or adiamond@acog.org