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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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| March 2008/Vol 8, Issue 3 |
You are here: Practice Issues > March 2008/Vol 8, Issue 3
Practice Management and Coding Update
American College of Obstetricians and Gynecologists (ACOG)
March 2008/Vol 8, Issue 3
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) CODING ADVICE: NOVASURE ENDOMETRIAL ABLATION CODING
2) DO YOU USE AN EMR TO WRITE AND SUBMIT PRESCRIPTIONS TO PHARMACIES?
3) NEW CMS REQUIREMENTS OF INFORMED CONSENT AFFECTS ALL PROVIDERS
4) EMR VENDOR CHALLENGE AT ACOG ANNUAL CLINICAL MEETING
5) RAC PROGRAM TO EXPAND NATIONALLY IN 2010
6) UHC AND INGENIX UNDER INVESTIGATION IN NEW YORK
7) SUBSCRIBE TO ACOG RSS FEEDS
8) ACOG LIVE WEBCASTS:
MARCH 11, 2008: PRECONCEPTION COUNSELING & PRENATAL TESTING FOR THE GENERALIST OBSTETRICIAN-GYNECOLOGIST
APRIL 8, 2008: PURSUING EXCELLENCE IN PERINATAL SAFETY AND QUALITY: MEETING THE CHALLENGE AND MAINTAINING ENGAGEMENT
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1) CODING ADVICE: NOVASURE ENDOMETRIAL ABLATION CODING
The NovaSure system is an FDA approved nonresectoscopic endometrial ablation device that uses electrical currents to perform endometrial ablation. ACOG’s Committee on Coding and Nomenclature has stated that an endometrial ablation performed with the use of the NovaSure device without hysteroscopy is reported with CPT-4 code 58353 (Endometrial ablation, thermal, without hysteroscopic guidance).
If hysteroscopy with endometrial sampling is performed at the same surgical setting as a NovaSure endometrial ablation, report code 58563 (Hysteroscopy, surgical; with endometrial ablation [e.g., endometrial resection, electrosurgical ablation, thermoablation]) instead.
http://www.acog.org/departments/dept_notice.cfm?recno=6&bulletin=4481
2) DO YOU USE AN EMR TO WRITE AND SUBMIT PRESCRIPTIONS TO PHARMACIES?
Most 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 new CMS regulation changes that will take effect on January 1, 2009. ACOG is participating in a nationwide program to help practices assess their ability to establish pharmacy connectivity using their current technology. Non-EMR users can also access this information for guidance on how to acquire e-prescribing technology and for the business and social cases for e-prescribing. For more information go to:
http://www.acog.org/departments/dept_notice.cfm?recno=19&bulletin=4479
3) NEW CMS REQUIREMENTS OF INFORMED CONSENT AFFECTS ALL PROVIDERS
CMS recently published revisions to the Hospital Interpretive Guidelines for Informed Consent. The guidelines affect providers who have privileges at covered facilities. Providers must follow the requirements for informed consent for all patients, not just Medicare and Medicaid patients
To read the new CMS interpretive guidelines (which were published to assist surveyors in application of the regulations), go to:
http://www.acog.org/departments/dept_notice.cfm?recno=19&bulletin=4473
4) EMR VENDOR CHALLENGE AT ACOG ANNUAL CLINICAL MEETING
ACOG's Committee on Ambulatory Practice Operations is sponsoring the 2nd Annual EMR "Vendor Challenge" from 9:00 am to 4:00 pm on Sunday, May 4th at ACOG’s Annual Clinical Meeting in New Orleans. Vendors will have a limited amount of time (30 minutes) to show how their product deals with a particular patient situation based on scenarios developed by the Committee. All vendors who participate in the Challenge will be available for follow up demonstrations on the Exhibit floor during the ACM. ACOG does not recommend any particular EMR product. For further information, visit:
http://www.acog.org/departments/dept_notice.cfm?recno=47&bulletin=4450
5) RAC PROGRAM TO EXPAND NATIONALLY IN 2010
CMS announced the results of a 2 year, 3 state demonstration project utilizing Recovery Audit Contractors (RACs). The RAC demonstration project was created by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA). The program is designed to find and correct improper Medicare payments paid to health care providers who participate in fee-for-service Medicare. Approximately 96% ($357.2 million) of $371.5 million in improper Medicare payments have been recovered from healthcare providers and suppliers, mostly inpatient facilities. The remaining 4% ($14.3 million) has been paid to providers who were underpaid for services. The RAC program will be a national program in January 1, 2010. For more information: http://www.cms.hhs.gov/RAC
6) UHC AND INGENIX UNDER INVESTIGATION IN NEW YORK
New York Attorney General Andrew Cuomo is investigating an alleged industry-wide scheme in which Ingenix (owned by United HealthCare) and insurance payers manipulated reimbursement rates. The investigation centers on the “usual, customary and reasonable” (UCR) rates calculated by Ingenix and used by insurance payers for out of network services. These UCR rates are alleged to have been kept low so as to shift a higher burden of payment to the patient who seeks out of network care.
http://www.oag.state.ny.us/press/2008/feb/feb13a_08.html
7) SUBSCRIBE TO ACOG RSS FEEDS
RSS (Really Simple Syndication) allows ACOG Fellows to keep up to date with new postings and updates from the ACOG website in an automated way. By subscribing to a feed, you receive a summary of recently added articles and links to the full articles. You can also access new information manually by clicking on the RSS icon on the ACOG homepage. For more information on the syndicated feeds available from ACOG, go to www.acog.org and click on the orange RSS icon at the top of the page.
8) ACOG LIVE WEBCASTS:
MARCH 11, 2008: PRECONCEPTION COUNSELING & PRENATAL TESTING FOR THE GENERALIST OBSTETRICIAN-GYNECOLOGIST
1:00 PM – 2:30 PM ET
Presenter: Deborah Driscoll, MD, FACOG
Cost: $49 Members; $59 non-members
Registration closes at noon ET on Monday, March 10
Preconception and prenatal counseling is an important component of patient care that provides patients with information regarding their risk for having a child with an inherited condition, chromosome abnormality or birth defect. It is an opportunity to provide advice on how to optimize the chances of having a healthy child. Today’s obstetrician-gynecologists need to be up-to-date on genetic carrier screening tests and prenatal tests for fetal chromosome abnormalities. At the conclusion of this course, participants will be able to:
Utilize a comprehensive family, medical and past obstetric and gynecologic history to assess risk for having a child with a genetic disorder or birth defect
Understand the importance of pre-test counseling, consent, documentation and respect for patient autonomy with regards to genetic screening tests
Screen patients for sickle cell disease and thalassemia, cystic fibrosis, fragile X mental retardation
Develop an approach to offering patients of Jewish ancestry carrier screening tests
Select and implement a screening strategy for Down syndrome in their practice
Interpret screening test results and indications for diagnostic testing
Discuss advantages, disadvantages and limitations of screening and diagnostic tests for fetal chromosome abnormalities.
For more information and to register, go to: http://www.acog.org/postgrad/pgpage.cfm?recno=460
APRIL 8, 2008: PURSUING EXCELLENCE IN PERINATAL SAFETY AND QUALITY: MEETING THE CHALLENGE AND MAINTAINING ENGAGEMENT
1:00 – 2:30 PM ET
Presenter: Roxanne Gardner
Cost: $49 Members; $59 non-members
Registration closes at noon ET on Monday, April 7
This webcast will review the issues and events that contribute to perinatal harm and their impact on obstetric liability. The characteristics of a Safety Culture and its relationship to obstetrical error will be highlighted. Benchmarks of high quality perinatal care, methods for evaluating perinatal team practice, and strategies for continued improvement in perinatal safety and quality will be discussed. After participating in this webcast, participants should be able to:
Review the issues and events that contribute to perinatal harm and their impact on obstetric liability
Review characteristics of a Safety Culture and the relationship between organizational safety culture and obstetric errors
Discuss the benchmarks of safe, high quality perinatal care and methods for their evaluation
Identify strategies for continued improvement in reliability and error reduction in obstetrics
For more information and to register, go to:
http://www.acog.org/postgrad/pgpage.cfm?recno=465
Physicians, practice administrators and staff will find ACOG Webcasts beneficial. 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