Posted on 23. Mar, 2009 by in Toolkit.
Ophthalmologists and optometrists who want to recoup a bonus from Medicare can choose to participate in the Physician Quality Reporting Initiative (PQRI) again — this time with a higher rate of return.
The basics: In 2008, the PQRI bonus was 1.5 percent for practices that met the measures. In 2009, PQRI pays a 2 percent bonus.
The first step in PQRI participation is focusing your reporting on measures the optometrist will often meet. According to CMS, the 2009 PQRI includes 153 reporting measures; however, only a handful will be relevant to eye doctors.
In 2009, CMS is retaining five eye care PQRI measures from 2008. Please click here to see the chart.
Posted on 23. Mar, 2009 by in Hot Coding Topics.
Most practices would agree that a 57.2 percent success rate isn’t overly impressive — but that’s exactly what CMS found in its recent analysis of PQRI submissions.
Almost 43 percent of the quality data codes (QDCs) that practices submitted to CMS were ineligible for the PQRI bonus because physicians reported them improperly, CMS noted in its Feb. 13 report, “Quality-Data Code Submissions Error Report.” The report analyzed PQRI submissions over the first three quarters of 2008.
For 2009, the PQRI incentive payment is two percent of your physician’s allowed charges under the Medicare physician fee schedule. If you’d like to keep that two percent flowing into your practice, avoid these errors that CMS found:
Posted on 23. Mar, 2009 by in Provider News.
With the Recovery Audit Contractor (RAC) program back in business, you can’t miss the chance to learn all there is to know about the RAC contractors and their habits. That’s why a new CMS transmittal may well be the most interesting reading material you’ve come across in a long while, reports Part B Insider.
CMS transmittal 148, dated March 6, offers updated advice on communication with RACs, points of contact, and an overview of the entire RAC process.
The transmittal offers some insight into the RAC exclusion program, noting …
Posted on 20. Mar, 2009 by in Toolkit.
Can’t remember which allergy tests refer to allergenic extracts and which are for biological substances, not to mention the billing method that you should use for each? Keep the six allergy test codes straight with this clip-and-save chart.
Posted on 20. Mar, 2009 by in Hot Coding Topics.
Reporting more than one chest x-ray for the same date can raise questions for payers. Are you accidentally reporting a single service more than once? If there was a second x-ray, was it medically necessary?
Answer your payer’s questions up front by using modifiers and the narrative field, and help your physician’s claims sail through the system.
Single View x 2? Think Mod 76
When radiologists interpret two x-rays on the same day that require the same code, coders need to investigate proper use of modifier 76 (Repeat procedure or service by same physician), says Sharon Wright, CPC, coding compliance auditor with Nemours health system in Jacksonville, Fla.
Posted on 20. Mar, 2009 by in Hot Coding Topics.
For “supine,” picture the similar-sounding “soup in the navel.” (Yes, said navel is an “innie.”) If the soup can stay in the navel without spilling, the patient is supine, or face up. If not, the patient is prone, or face down.
Posted on 20. Mar, 2009 by in Provider News.
Legislators worry about just that, reports The Wall Street Journal. Congress is kicking around a bill that would require companies and doctors to disclose consultant and speaking gigs. Big Pharma largely supports the bill because it would override the “patchwork” of new state laws regulating relationships between drug companies and clinicians.
Posted on 19. Mar, 2009 by in Hot Coding Topics.
“Salivary gland endoscopy” involves placing a tiny camera through the salivary ducts and into the glands, Dr. Koopmann told attendees at a recent Coding Institute conference in Las Vegas.
This new procedure removes salivary stones and other obstructions in the salivary glands, which can cause infection, said Dr. Koopmann, an otolaryngologist and reimbursement expert at the University of Michigan Medical Center in Ann Arbor.
For salivary gland endoscopy, use 42699 (Unlisted procedure, salivary glands or ducts), says Dr. Koopmann. Why use an unlisted procedure code? The surgery is complicated and the equipment is expensive, so surgeons want the procedure to have its own code.
Posted on 19. Mar, 2009 by in Provider News.
And Wal-Mart’s looking to slash prices. $300K to install an EMR system? Phooey, says the big box retailer.
Through Sam’s Club, the company plans to offer EMR for a $25,000 start-up fee for the first physician in the practice, $10,000 for each additional doctor, and an annual maintenance fee of about $5,000 a year … More…
Posted on 19. Mar, 2009 by in Toolkit.
Several factors come into play when you’re successfully coding facet joint injections – spinal level, the number of injections, unilateral versus bilateral, and even the type of substance injected.