[Coding] ACOG Coding and Practice Management Update

Anne Diamond ADiamond at acog.org
Fri Jul 8 16:53:21 EDT 2011


              Practice Management and Coding Update 
American Congress of Obstetricians and Gynecologists (ACOG)
              July 2011/Vol. 11, Issue 7
 
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 Tip: BRUSH UP ON ICD-10
2) ACOG ICD-10 CODING WEBCAST on AUGUST 9
3) ACOG COMMITTEE SERVICE APPLICATION PERIOD OPENS FOR FELLOWS
4) NEW CMS INITIATIVE TO FIGHT FRAUD & ABUSE
5) OIG HEAT PROVIDER COMPLIANCE TRAINING WEBCAST ARCHIVE
6) NATIONAL HEALTH INSURER REPORT CARD
7) HHS OIG LEIE DATABASE
8) IRS MILEAGE RATES 
9) PHYSICIAN/HOSPITAL QUALITY COMPARISON TOOL FOR PATIENTS
10) AHRQ WORKFLOW ASSESSMENT FOR HEALTH IT TOOLKIT
11) PROPOSED RULES RELEASED
12) FISCAL SURVEY OF STATES
13) ACOG WEBCASTS and ARCHIVES:
July 12, 2011: Robotic Surgery: The Promise and the Peril
 
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1) Coding Tip: BRUSH UP ON ICD-10
CMS and AAPC collaborated on the ICD-10 Code-A-Thon on April 26, 2011.
Archived materials have been posted to the on the CMS ICD-10 website in
the Latest News ( http://www.cms.gov/ICD10/02b_Latest_News.asp#TopOfPage
) section. A transcript and audio of the AAPC and CMS presentations are
available as well as the PowerPoint slide presentation on ICD-10 and
Version 5010. 
For more information on ICD-10, visit http://www.cms.gov/icd10/
 
2) ACOG ICD-10 CODING WEBCAST on AUGUST 9
 
Title:  ICD-9 to ICD-10: What to Expect
Date: Tuesday, August 9, 2011 
Time: 1:00 – 2:30 PM ET
Presenter: Emily Hill
Cost: $99 ACOG Members and AAPC members; $115 Non-members
Registration and more information:
http://www.acog.org/postgrad/pgpage.cfm?recno=561
 
This webcast will discuss the importance of ICD coding to a physician’s
practice including its role in quality measures. The primary
distinctions between ICD-9 and ICD-10 will be reviewed with examples
offered for OB/Gyn practices. The basic principles of ICD coding will be
addressed and their applicability to ICD-10 explored. Finally, the
discussion will identify key challenges and opportunities posed by the
transition to ICD-10 along with possible strategies to address these
issues.
 
3) ACOG COMMITTEE SERVICE APPLICATION PERIOD OPENS FOR FELLOWS
ACOG Fellows who are interested is serving on one of the College or
Congress Committees should complete and submit an application form
before September 9, 2011. President Elect James T. Breeden, MD, will
make committee appointments in November 2011 for terms beginning in May
2012.
ACOG members can access the application form and a list of the
committees at: http://www.acog.org/departments/dept_web.cfm?recno=42
 
4) NEW CMS INITIATIVE TO FIGHT FRAUD & ABUSE
Beginning July 1, CMS will use predictive modeling technology to
identify potentially fraudulent Medicare claims on a nationwide basis
before they are paid. Predictive modeling, similar to the technology
currently used by credit card companies, will allow the use of real-time
data to identify fraudulent claims thus shifting the focus from "pay and
chase" to prevention. For more information:
http://www.healthcare.gov/news/factsheets/fraud03152011a.html
 
5) OIG HEAT PROVIDER COMPLIANCE TRAINING WEBCAST ARCHIVE
The HHS Office of the Inspector General Health Care Fraud Prevention
and Enforcement Action Team has posted a video recording of the HEAT
Provider Compliance Training session that was held on May 18, 2011. The
session recording is 3 hours and 45 minutes or you can choose individual
modules. The video, individual modules, slides, and related material can
be accessed at: http://oig.hhs.gov/newsroom/video/index.asp
   
6) NATIONAL HEALTH INSURER REPORT CARD
The AMA has released the results of its fourth annual National Health
Insurer Report Card ( http://www.ama-assn.org/go/reportcard ), which
highlights the strengths and weaknesses of the claims processing systems
used by eight of the nation’s largest insurers. This is a key initiative
of the AMA’s “Heal the Claims Process”™ campaign, which seeks to
eliminate waste from the claims process and free up time and resources
to devote to patient care.
 
Visit www.ama-assn.org/go/reportcard to view the full report card
results, access the supporting documentation and view an archived
webinar.
 
Visit www.ama-assn.org/go/healthatclaim to learn more about the AMA’s
“Heal the Claims Process” campaign and how you can get involved. 
  
7) HHS OIG LIST OF EXCLUDED INDIVIDUALS & ENTERPRISES DATABASE
Just a reminder to those practices who are hiring this summer: If you
participate in a federally funded program, (e.g. Medicare, Tricare,
etc.) be sure to check out the prospective candidate on the HHS Office
of the Inspector General (OIG) List of Excluded Individuals and
Enterprises (LEIE). More information and access to the online searchable
database is available at: http://oig.hhs.gov/exclusions/index.asp
 
8) IRS MILEAGE RATES 
The IRS has announced an increase in the optional standard mileage
rates for the final six months of 2011. The rate will increase to 55.5
cents a mile for all business miles driven from July 1, 2011, through
Dec. 31, 2011. This is an increase from the 51 cent rate in effect for
the first six months of 2011.
Read the IRS announcement at:
http://www.irs.gov/newsroom/article/0,,id=240903,00.html
 
9) PHYSICIAN/HOSPITAL QUALITY COMPARISON TOOL FOR PATIENTS
The Robert Wood Johnson Foundation has launched an online directory (
http://www.rwjf.org/qualityequality/product.jsp?id=71857 ) of free and
publicly available resources on hospital and physician performance. The
directory links to 224 reports that use performance measurement data
based on nationally recognized measurement sets for quality of care in
inpatient or outpatient settings; include measures for process of care,
outcome of care, cost, efficiency or patient experience; and include
comparative information for facilities or providers in a defined
location or nationally.
http://www.rwjf.org/qualityequality/product.jsp?id=71857
 
10) AHRQ WORKFLOW ASSESSMENT FOR HEALTH IT TOOLKIT
AHRQ has funded the University of Wisconsin-Madison’s Center for
Quality and Productivity Improvement in the development of a toolkit to
help small to medium sized practices in workflow analysis and redesign
before, during, and after HIT implementation. Workflow Assessment for
Health IT is free and includes tools to analyze workflow, provides
examples of workflow analysis and redesign, and describes the
experiences of other organizations. For more information and to access
the toolkit go to http://healthit.ahrq.gov/workflow 
 
11) PROPOSED RULES RELEASED
It has been a busy summer so far for HHS. CMS has released several
proposed rules, most recently, the Proposed Physician Fee Schedule which
proposes a 29.5% reduction in reimbursement under the Sustainable Growth
Rate (SGR) formula beginning January 1, 2012. ACOG will submit comments
to the Secretary on this proposed rule. Physician Fee Schedule Proposed
Rule (
http://www.cms.gov/apps/media/press/factsheet.asp?Counter=4011&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&keywordType=All&chkNewsType=6&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date
)
 
Other proposed rules which you may find of interest are:
 
Proposed Rule for Hospital Outpatient Departments and Ambulatory
Surgical Centers (
http://www.cms.gov/apps/media/press/factsheet.asp?Counter=4008&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&keywordType=All&chkNewsType=6&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date
)
Comments are due to CMS by August 31.
 
Proposed Rule: HIPAA Privacy Rule Accounting of Disclosures Under the
Health Information Technology for Economic and Clinical Health Act (
http://www.federalregister.gov/articles/2011/05/31/2011-13297/hipaa-privacy-rule-accounting-of-disclosures-under-the-health-information-technology-for-economic
)
Summary information (
http://www.hhs.gov/news/press/2011pres/05/20110531c.html ). Comments are
due to OCR by August 1.
 
Administration Simplification: Adoption of Operating Rules for
Eligibility for a Health Plan and Health Care Claim Transactions (
http://www.gpo.gov/fdsys/pkg/FR-2011-07-08/pdf/2011-16834.pdf ). Summary
information ( http://www.hhs.gov/news/press/2011pres/06/20110630a.html
). This is an Interim Final Rule with comment period. Comments are due
to CMS by September 6.
 
Medicare Program; Clinical Laboratory Fee Schedule: Signature on
Requisition (
http://www.gpo.gov/fdsys/pkg/FR-2011-06-30/html/2011-16366.htm )
CMS proposes retracting the new rule that requires the signature of a
physician or qualified non- physician practitioner on a requisition for
clinical diagnostic laboratory tests paid under the clinical laboratory
fee schedule. Comments are due to CMS by August 29.
 
Medicare Program; Availability of Medicare Data for Performance
Measurement (
http://www.gpo.gov/fdsys/pkg/FR-2011-06-08/pdf/2011-14003.pdf )
CMS has proposed a rule regarding the release and use of Medicare
claims data to compare physician performance. "Qualified entities" would
be able to access the Medicare claims data beginning in 2012 and combine
it with private payer data to produce public reports on physicians,
hospitals and other health care providers. Summary information (
http://www.cms.gov/apps/media/press/release.asp?Counter=3977&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&keywordType=All&chkNewsType=1%2C+2%2C+3%2C+4%2C+5&intPage=&showAll=&pYear=&year=&desc=false&cboOrder=date
). Comments are due to CMS by August 8.
 
Medicare Program; Proposed Changes to the Electronic Prescribing (eRx)
Incentive Program (
http://www.gpo.gov/fdsys/pkg/FR-2011-06-01/html/2011-13463.htm ) 
Summary information (
http://www.cms.gov/apps/media/press/factsheet.asp?Counter=3971&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&keywordType=All&chkNewsType=6&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date
). Comments are due to CMS by July 25.
 
If you are having trouble with the links, you can also find the
information in the Federal Register at:
http://www.gpo.gov/fdsys/browse/collection.action?collectionCode=FR
 
12) Fiscal Survey of States
Many states plan to further reduce Medicaid reimbursements to doctors,
hospitals and other providers as their new budget year begins in July.
Overall, Medicaid enrollment increased as the economy worsened. For more
information, access the Fiscal Survey of States (
http://www.nasbo.org/LinkClick.aspx?fileticket=yNV8Jv3X7Is%3d&tabid=38 )
by the National Governor's Association and the National Association of
State Budget Officers. See Chapter 4 for Medicaid information.
 
13) ACOG WEBCASTS ( http://www.acog.org/postgrad/index.cfm?webcast )
and ARCHIVES (
https://live.blueskybroadcast.com/bsb/client/CL_DEFAULT.asp?Client=490885&title=Home
):
 
July 12, 2011: Robotic Surgery: The Promise and the Peril
Time: 1:00 – 2:30 PM ET
Presenter: David E. Cohn, MD, FACOG
Cost: $99 ACOG Members; $115 Non-members
Registration: http://www.acog.org/postgrad/pgpage.cfm?recno=564
 
Over the last 3 decades, there has been an increasing interest in novel
surgical approaches that aim to maximize patient outcome while
decreasing surgical morbidity. Recently, advances in computer-aided
(robotic) surgery have led to the clearance of robotic surgery for
urologic and gynecologic indications. As the number of robotic
gynecologic cases has dramatically risen over the last 5 years, emerging
data demonstrates the feasibility of robotic hysterectomy. Patient
outcomes have been reported from single and multi-institutional series
and suggest outcomes similar to other minimally-invasive techniques.
However, the cost, learning curve, and impact of robotic surgery on
surgical training may limit the widespread adoption of this approach. 
 
At the conclusion of this course, participants will be able to: 
·         Recognize the history of computer-aided and robotic surgery
·         Understand the role of robotic surgery in gynecologic
surgery
·         Describe the learning curve of robotic surgery
·         Be familiar with the risks and benefits of robotic surgery in
gynecology
·         Appreciate the utility and limitations of robotic surgery for
gynecologic conditions 
 
ACOG WEBCAST ARCHIVES (
https://live.blueskybroadcast.com/bsb/client/CL_DEFAULT.asp?Client=490885&title=Home
):
·         Coding for Office Based Ob/Gyn Procedures
·         Coding for Consultation Services
·         Coding for Wound Repair: Post-operative and Postpartum
·         Vaginal Birth after Cesarean Section: What's New and What's
Not
·         The VRQC Program: Using Standardized Worksheets as Part of
the Peer Review Process
Click here to access ACOG's OnDemand presentations (
https://live.blueskybroadcast.com/bsb/client/CL_DEFAULT.asp?Client=490885&title=Home
).
 
ACCME Accreditation
The American College of Obstetricians and Gynecologists (ACOG) is
accredited by the Accreditation Council for Continuing Medical Education
(ACCME) to provide continuing medical education for physicians. 
 
AMA CME Category 1 Credit and ACOG Cognate Credit
The American College of Obstetricians and Gynecologists (ACOG)
designates this educational activity for a maximum of 2 category 1
credits toward the AMA Physician's Recognition Award or up to a maximum
of 2 category 1 ACOG cognate credits. Each physician should claim only
those credits that he/she actually spent in the activity.
 
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