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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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| August 2008/Vol 8, Issue 8 |
You are here: Practice Issues > August 2008/Vol 8, Issue 8
Practice Management and Coding Update
American College of Obstetricians and Gynecologists (ACOG)
August 2008/Vol 8, Issue 8
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 EDITS AVAILABLE ON THE MEMBER SIDE OF WEBSITE
2) MEDICARE LEGISLATION UPDATE - CONGRESS OVERRIDES VETO
3) Your Help Needed with ACOG/AMA Physician Practice Survey
4) MEDICARE E-PRESCRIBING BONUSES/PENALTIES
5) ACOG ONLINE HEALTH ECONOMICS SURVEY
6) AMA NATIONAL HEALTH INSURER REPORT CARD – CLAIMS PROCESSING
7) CCHIT – EHR DECISIONS
8) PhRMA REVISES VOLUNTARY MARKETING CODE
9) JOINT COMMISSION SENTINEL EVENT ALERT TARGETS STAFF’S BAD BEHAVIOR
10) ACOG LIVE WEBCASTS:
AUGUST 12, 2008: INTERRUPTED PREGNANCY CODING
SEPTEMBER 9, 2008: E/M CODING AND MEDICAL NECESSITY
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1) CCI EDITS AVAILABLE ON THE MEMBER SIDE OF WEBSITE
Correct Coding Initiative (CCI) edits effective July 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:
http://www.acog.org/departments/dept_notice.cfm?recno=6&bulletin=1127&membersOnly=TRUE
The following codes were revised for the third quarter:
11004, 11006, 11042, 11043, 49021, 49041, 49061, 57284, 58541, 58542, 58548, 58823, 77080, 77081, 99217, 99218, 99219, 99220, 99221, 99222, 99223, 99231, 99232, 99233, 99234, 99235, 99236, 99238, 99239, 99251, 99252, 99253, 99254, 99255, 99283, 99284, 99285
2) MEDICARE LEGISLATION UPDATE - CONGRESS OVERRIDES VETO
On July 15th, Congress overrode the President’s veto and the Medicare Improvements for Patients and Providers Act (HR 6331) became law. The bill cancels a 10.6% cut in reimbursements to providers and freezes payments at the previous 2008 rate. In 2009, providers will get a 1.1% increase in reimbursements. By now, most contractors will have adjusted their payment systems to pay claims with the +0.5% update. Claims that were processed with the 10.6% cut will be automatically reprocessed.
http://www.cms.hhs.gov/PhysicianFeeSched/01_overview.asp
3) Your Help Needed with ACOG/AMA Physician Practice Survey
Results from the survey will be used to influence national decision makers. The response rate for ob/gyns had been very low, and we want to encourage broader participation. For more information, go to http://www.acog.org/departments/dept_notice.cfm?recno=19&bulletin=4014
4) MEDICARE E-PRESCRIBING BONUSES/PENALTIES
Medicare providers who prescribe for Part D patients can earn a bonus payment incentive of 2% when using qualified e-prescribing systems in 2009 and 2010; a 1% bonus in 2011 and 2012, and a 0.5% bonus in 2013. Providers who fail to e-prescribe by 2012 will see a reduction in payments of 2%. However, there is a provision for a hardship exception for providers who are unable to use a qualified e-prescribing system.
For more information: http://www.acog.org/departments/dept_notice.cfm?recno=19&bulletin=4633
5) ACOG ONLINE HEALTH ECONOMICS SURVEY
ACOG physicians currently in active practice are requested to complete ACOG’s online socioeconomic survey. Not to be confused with the AMA/ACOG survey, the information gathered in the ACOG online survey guides our advocacy and educational efforts on your behalf. Please take the time (20-30 minutes) to complete the questionnaire and add your information to that of other ACOG Fellows. For more information, the reports from the previous 2003 ACOG survey, and the link to the online survey, go to: http://www.acog.org/departments/dept_notice.cfm?recno=19&bulletin=4587
To go directly to the online survey, go to: ACOG Survey.
6) AMA NATIONAL HEALTH INSURER REPORT CARD – CLAIMS PROCESSING
The AMA has released the Health Insurer Report Card on claims processing. The report is a source of information on the timeliness, transparency and accuracy of claims processing by the health insurance companies that are responsible for paying medical bills. The plans covered in this first report include: Aetna, Anthem BC/BS, Cigna, Coventry, Health Net, Humana, United Health Care, and Medicare. To access the report and other information, go to:
http://www.ama-assn.org/ama/pub/category/18660.html
7) CCHIT – EHR DECISIONS
The Certification Commission for Health Information Technology (CCHIT) is a recognized certification body for electronic health records. To help practices with the EMR selection process, CCHIT publishes EHR Decisions online. To access their articles, go to: http://ehrdecisions.com/
For a listing of CCHIT certified EMRs, go to www.cchit.org.
8) PhRMA REVISES VOLUNTARY MARKETING CODE
The Pharmaceutical Research and Manufacturers of America have announced revisions to the PhRMA Code on Interactions with Healthcare Professionals. The new rules are voluntary and will take effect in January 2009.
Some of the changes you may notice when dealing with drug reps are:
Distribution of non-educational items, i.e. pens, mugs, etc. will no longer be permitted;
Limits on payments to physicians who deliver educational lectures to colleagues;
Restaurant meals are no longer allowed, but in-office meals in conjunction with educational presentations are still permitted.
There will be no changes in the speaking and consulting arrangements drug companies make with physicians.
For more information, go to:
http://www.phrma.org/news_room/press_releases/phrma_code_reinforces_commitment_to_responsible_interactions_with_healthcare_professionals/
9) JOINT COMMISSION SENTINEL EVENT ALERT #40 ON STAFF’S BAD BEHAVIOR
The Joint Commission warns that hostile behavior and rude language by healthcare workers “poses a serious threat to patient safety and overall quality of care.” New standards to take effect January 1, 2009 will require institutions to develop Codes of Conduct defining acceptable and unacceptable behavior. Intimidating and disruptive behaviors includes verbal outbursts and/or abuse, condescending or demeaning attitudes, refusing to take part in assigned duties, and physical threats. For more information go to:
http://www.jointcommission.org/NewsRoom/NewsReleases/nr_07_09_08.htm
For the full text of Sentinel Event #40, go to:
http://www.jointcommission.org/SentinelEvents/SentinelEventAlert/sea_40.htm
10) ACOG LIVE WEBCASTS:
August 12, 2008: INTERRUPTED PREGNANCY CODING
1:00 – 2:30 PM ET
Presenter: Terry Tropin, RHIA, CPC, CCS-P, ACS-OB
Cost: $49 Members; $59 Non-members
Registration closes at noon ET on Monday, August 11
Interrupted pregnancy coding continues to be a problem area for every OB-Gyn office. This course will walk you through coding different scenarios such as missed abortion, spontaneous abortion, induced abortion for medical necessity as well as discussing how to capture prenatal visits when there has been a provider change or insurance change.
For more information and to register, go to:
http://www.acog.org/postgrad/pgpage.cfm?recno=456
September 9, 2008: E/M CODING AND MEDICAL NECESSITY
1:00 – 2:30 PM ET
Presenter: Emily Hill, PA
Cost: $49 Members; $59 Non-members
Registration closes at noon ET on Monday, September 5
This webcast explores the concept of medical necessity in the selection of an E/M level of care. It examines the role of medical decision making and the nature of the presenting problem in establishing the medical necessity of the service. The course discusses strategies to ensure the documentation in the medical record reflects medical necessity and supports the level of care.
For more information and to register, go to:
http://www.acog.org/postgrad/pgpage.cfm?recno=454
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