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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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| April 2008/Vol 8, Issue 4 |
You are here: Practice Issues > April 2008/Vol 8, Issue 4
Practice Management and Coding Update
American College of Obstetricians and Gynecologists (ACOG)
April 2008/Vol 8, Issue 4
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: LAPAROSCOPIC HYSTERECTOMY PROCEDURES - 2008
2) NCCI CODE PAIRS 57284/57287 and 57284/57288 DELETION
3) NEW CMS ADVANCED BENEFICIARY NOTICE (ABN)
4) EMR VENDOR CHALLENGE AT ACOG ANNUAL CLINICAL MEETING
5) CCHIT OFFERS NEW ONLINE RESOURCE FOR PHYSICIANS CONSIDERING EMRs
6) TAMPER RESISTANT DEADLINE – APRIL 1
7) CMS SEEKS PARTICIPATION IN EHR DEMO PROJECT
8) ACOG LIVE WEBCASTS:
APRIL 8, 2008: PURSUING EXCELLENCE IN PERINATAL SAFETY AND QUALITY: MEETING THE CHALLENGE AND MAINTAINING ENGAGEMENT
MAY 13, 2008: Coding with Modifiers
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1) CODING ADVICE: In CPT 2008, the American Medical Association (AMA) published the total laparoscopic hysterectomy (TLH) set of codes (58570-58573). This, in addition to the laparoscopic radical hysterectomy with pelvic lymphadenectomy code (58548), is the third set of CPT codes addressing the laparoscopic approach to hysterectomy. The other CPT code sets are the laparoscopy with vaginal hysterectomy (LAVH) (58550-58554) and laparoscopic supracervical hysterectomy (LSH) (58541–58544) code sets. Each of the code sets are subdivided into uteri less than or greater than 250 grams and with or without removal of tube(s) and/or ovary(s). For further discussion of these sets of codes and a downloadable reference chart go to: http://www.acog.org/departments/dept_notice.cfm?recno=6&bulletin=4528
2) NCCI CODE PAIRS 57284/57287 and 57284/57288 DELETION
An error was made on two National Correct Coding Initiative edits scheduled to be deleted on January 1, 2008. The deletion date was inadvertently omitted on both NCCI edits as they appear in the Medicare claims processing systems and on CMS website. The code pairs are column 1 CPT code 57284 and column 2 CPT code 57287 AND column 1 CPT code 57284 and column 2 CPT code 57288. These two NCCI edits were to be deleted with a deletion date of 1/1/2008 in final NCCI version 14.0 implemented on January 1, 2008. The corrections will be made as soon as feasiblely possible and will appear in the final NCCI version 14.2 on July 1, 2008.
Providers may hold their claims for the 57287 and 57288 services which would be denied if the NCCI edits were applied OR resubmit these claims after the correction is implemented on July 1, 2008. Claims that have already been submitted and paid by Medicare can be resubmitted after July 1, 2008, for the addition reimbursement. Correct Coding Solutions LLC, the NCCI contractor, apologizes for this unintentional error.
3) NEW CMS ADVANCED BENEFICIARY NOTICE (ABN)
A revised Advanced Beneficiary Notice of Non-Coverage (ABN) was released by CMS on March 3, 2008. The new form replaces the ABN-G and the ABN-L forms. All providers must use the new forms by September 1 for all situations where Medicare payment is expected to be denied. For more information and to download a copy of the new form and instructions, go to:
http://www.cms.hhs.gov/BNI/02_ABNGABNL.asp
4) EMR VENDOR CHALLENGE 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 different vendors in action. 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. For a list of participating vendors and other information, visit: http://www.acog.org/departments/dept_notice.cfm?recno=47&bulletin=4450
The schedule for the Challenge will also be posted on this site by April 21.
5) CCHIT OFFERS NEW ONLINE RESOURCE FOR PHYSICIANS CONSIDERING EMRs
The Certification Commission for Healthcare Information Technology has a new online resource to help physicians in their readiness assessment and related issues to choosing an EMR. EHR Decisions is available through the following link: http://ehrdecisions.com/
6) TAMPER RESISTANT DEADLINE – APRIL 1
Written Medicaid prescriptions are required to have at least one feature to prevent unauthorized copying, modification or counterfeiting by April 1. Written prescriptions must have one feature from all three categories by October 1. Electronic, faxed or phoned in prescriptions are not affected, nor are prescriptions paid for by Medicaid managed care organization.
For more information: http://www.acog.org/departments/dept_notice.cfm?recno=19&bulletin=4459.
The National Association of State Medicaid Directors has vendor and state specific information at:
http://www.nasmd.org/issues/trpp.asp
7) CMS SEEKS PARTICIPATION IN EHR DEMO PROJECT
Medicare is looking for 12 communities across the country that can bring together a broad cross-section of community leadership, leverage resources, and recruit small and medium-sized primary care physician practices willing to provide the evidence that electronic health records (EHR) can improve the quality of patient care. Medicare’s objective, with this demonstration, is to launch the construction of an interconnected electronic information system quickly and seamlessly. As many as 1,200 physician practices nationwide could be eligible for incentive payments of up to $58,000 per physician—up to $290,000 per practice—over the five-year life of the demonstration. Incentives would be based on a practice’s level of EHR use, and for reporting and performance on 26 clinical quality measures.
To learn more about the new EHR demonstration project, visit: http://www.cms.hhs.gov/DemoProjectsEvalRpts/downloads/2008_Electronic_Health_Records_Demonstration.pdf.
Email EHR_Demo@cms.hhs.gov or EHR_Demo_communityselections@cms.hhs.gov for more information about community selection.
8) ACOG LIVE WEBCASTS:
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
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