[Coding] ACOG Coding and Practice Management Update

Anne Diamond ADiamond at acog.org
Wed Aug 31 10:10:26 EDT 2011


              Practice Management and Coding Update 
American Congress of Obstetricians and Gynecologists (ACOG)
              September 2011/Vol. 11, Issue 9
 
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) UPDATED ICD-9 CODE SET EFFECTIVE OCTOBER 1 
2) ICD-10 IS INEVITABLE
3) NEW ABN FORM – NOVEMBER 1 DEADLINE
4) MEDICARE ENROLLMENT RE-VALIDATION
5) ACOG WEBCAST ARCHIVES (
https://live.blueskybroadcast.com/bsb/client/CL_DEFAULT.asp?Client=490885&title=Home
):
6) MACs TO ISSUE RAC DEMAND LETTERS 
7) FACT SHEET: CMS OVERPAYMENT COLLECTION PROCESS 
8) SURGICAL SPECIALTY SOCIETIES 2011 PHYSICIANS AS ASSISTANTS AT
SURGERY STUDY
9) FAIR HEALTH MEDICAL COST LOOKUP FOR OUT-OF-NETWORK COSTS
10) STANDARDIZED PLAN SUMMARIES PROPOSED
11) FREE e-PRESCRIBING GUIDE 
12) ACOG LIVE WEBCASTS ( http://www.acog.org/postgrad/index.cfm?webcast
):
September 13, 2011: Communication and Cultural Sensitivity
October 11, 2011: Global Surgical Package Coding
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1) UPDATED ICD-9 CODE SET EFFECTIVE OCTOBER 1 
There are new, expanded and revised ICD-9 codes that take effect on
October 1. HIPAA requires providers to use the medical code set that is
in effect at the time the service is provided. 
To see the ICD-9 codes that are of interest to ob-gyns, go to:
http://www.acog.org/departments/dept_notice.cfm?recno=6&bulletin=5356
 
2) ICD-10 IS INEVITABLE
ACOG can help you prepare so that you will be ready for ICD-10 in 2013.
 Visit ACOG's NEW ICD-10 webpage for information and links to other
helpful resources. 
http://www.acog.org/departments/dept_notice.cfm?recno=6&bulletin=5783
 
3) NEW ABN FORM – NOVEMBER 1 DEADLINE
A new Advanced Beneficiary Notice of Non-coverage (ABN) form must be
used by November 1, 2011 and The Centers for Medicare and Medicaid
Services (CMS) is encouraging providers to begin using it now. The new
ABN form has a release date of 3/2011 printed in the lower left hand
corner. Any ABNs issued after November 1 with the release date of 3/2008
in the lower left hand corner will be considered invalid. Download the
new form and instructions at: http://www.cms.gov/BNI/02_ABN.asp
 
4) MEDICARE ENROLLMENT RE-VALIDATION
All providers and suppliers who enrolled in the Medicare program prior
to Friday, March 25, 2011, will be required to re-validate their
enrollment under new risk screening criteria required by the Affordable
Care Act (section 6401a). Between now and March 23, 2013, Medicare
Administrative Contractors (MACs) will send out notices to begin the
re-validation process for each provider and supplier. Providers who
receive a re-validation request from their Medicare contractor are
required to furnish all necessary information within 60 calendar days of
the request. Providers should not re-validate until they receive notice
from their Medicare contractor.
 
For more information see the Medicare Learning Network article, Further
Details on the Revalidation of Provider Enrollment, at
http://www.cms.gov/MLNMattersArticles/downloads/SE1126.pdf
 
5) ACOG WEBCAST ARCHIVES (
https://live.blueskybroadcast.com/bsb/client/CL_DEFAULT.asp?Client=490885&title=Home
):
The following webcast archives are available on the On Demand side of
the ACOG Webinar Registration page:
·         ICD-9 to ICD-10: What to Expect
·         Coding for Office Based Ob/Gyn Procedures
·         Coding for Consultation Services
·         Coding for Wound Repair
·         Robotic Surgery in Gynecology: The Promise and the Peril
·         Vaginal Birth after Cesarean Section: What's New and What's
Not
·         ACOG VRQC Program: Using Standardized Worksheets for Peer
Review
First time users must register and set up a password.
Click here to access ACOG's OnDemand presentations (
https://live.blueskybroadcast.com/bsb/client/CL_DEFAULT.asp?Client=490885&title=Home
).
 
6) MACs TO ISSUE RAC DEMAND LETTERS 
Beginning January 3, 2012, Recovery Audit Contractors (RACs) will
transfer the responsibility for issuing demand letters to Medicare
Administrative Contractors (MACs). The MACs will issue the demand
letters to collect RAC-identified overpayments following the same
processes used to collect other overpayments from providers. (See #7
below). CMS says that this change "reflects the program's desire to
increase consistency and efficiency through automation." This change was
made to resolve confusion and avoid timing issues and delays in issuing
the RAC recoupment letters. Providers will be instructed to contact
their MACs with any administrative questions about the demand but should
continue to contact RACs with specific questions relating to the audits.

https://www.cms.gov/MLNMattersArticles/downloads/MM7436.pdf
 
7) FACT SHEET: CMS OVERPAYMENT COLLECTION PROCESS 
“The Medicare Overpayment Collection Process” fact sheet includes
information about demand letters, appeals and repayment plans. The fact
sheet was revised in July and is now available for download from CMS. 
http://www.cms.gov/MLNProducts/downloads/OverpaymentBrochure508-09.pdf
 
8) SURGICAL SPECIALTY SOCIETIES 2011 PHYSICIANS AS ASSISTANTS AT
SURGERY STUDY
The American College of Surgeons (ACS) and 20 other surgical specialty
organizations have jointly published the sixth edition of Physicians as
Assistants at Surgery, a guide that indicates whether an operation may
call for the use of a physician as an assistant. This guide can be very
useful when dealing with payers. For more information and to access the
guide, go to:
http://www.acog.org/departments/dept_notice.cfm?recno=19&bulletin=5779
 
9) FAIR HEALTH MEDICAL COST LOOKUP FOR OUT-OF-NETWORK COSTS
Fair Health is an independent, non-profit organization that came into
existence as a result of the settlement in New York regarding
out-of-network reimbursement rates. Their mission is to "help ensure
fairness and transparency in out-of-network reimbursement." You can sign
up for their e-updates, Fair Health Access at:
http://fairhealthus.org/.
 
New this month - On the consumer side of their website, they have
developed the FH Consumer Cost Lookup (
http://www.fairhealthconsumer.org/ ) to help patients understand
out-of-network charges and out-of-pocket expenses. The website just
added a cost look-up tool for medical costs including obstetric
information. Consumers are limited to 20 "look-ups" a week.
www.fairhealthconsumer.org
 
10) STANDARDIZED INSURANCE PLAN SUMMARIES PROPOSED
HHS has released a proposed standard form for insurers to summarize
their policies so that consumers can compare coverage, deductibles and
costs. The health reform law requires insurers and employers who offer
health insurance to provide the forms to their beneficiaries by March
23, 2012. However, these forms are still a work in progress and insurers
are requesting an extension of the March deadline. The proposed rule was
published in the Federal Register on August 22. The public comment
period closes on October 21, 2011. View and comment on the proposed rule
online at www.regulations.gov. (DOC ID: HHS_FRDOC_0001-0418).  
View the proposed standardized forms at:
http://www.healthcare.gov/news/factsheets/labels08172011b.pdf
 
11) FREE 2011 e-PRESCRIBING GUIDE 
An updated version of the Clinician's Guide to e-Prescribing has been
released. The guide was originally developed in 2008 by the American
Academy of Family Physicians, the American College of Physicians, the
American Medical Association, the Center for Improving Medication
Management, eHealth Initiative, and Medical Group Management
Association. The 2011 updated guide provides: information on meeting
"meaningful use"; details on new Medicare e-prescribing requirements;
e-prescribing of controlled substances; frequently asked questions; and
a buyer's guide. The free guide can be downloaded from any of the links
below.
 
AMA:
http://www.ama-assn.org/resources/doc/hit/clinicians-guide-erx.pdf
Center for Improving Medication Management: http://www.thecimm.org/
eHealth Initiative: http://www.ehealthinitiative.org/reports.html
MGMA: http://www.mgma.com/WorkArea/DownloadAsset.aspx?id=1248619
 
12) ACOG LIVE WEBCASTS ( http://www.acog.org/postgrad/index.cfm?webcast
):
 
September 13, 2011: Communication and Cultural Sensitivity
Time: 1:00 – 2:30 PM ET
Presenter: Kenneth E. Brown, MD, FACOG
Cost: $99 ACOG Members; $115 Non-members
Registration: http://www.acog.org/postgrad/pgpage.cfm?recno=568
 
This webcast will address the emotional impact of medical errors on
obstetrician-gynecologists and suggest methods for coping. After
participating in this webcast, participants should be able to:
·         Discuss the impact of medical errors on the physical and
psychological well being of involved health care providers
·         Identify the common results of physician distress following
involvement in medical errors
·         Describe the major barriers to physicians pursuing counseling
after involvement in medical errors
·         Explain organizational approaches to supporting health care
professionals after medical errors
 
October 11, 2011: GLOBAL SURGICAL PACKAGE CODING
Time: 1:00 – 2:30 PM ET
Presenter: Brad Hart, MBA, MS, CMPE, CPC, COBGC
Cost: $99 ACOG Members and AAPC members; $115 Non-members
Registration: http://www.acog.org/postgrad/pgpage.cfm?recno=566
 
At the conclusion of this webcast participants will be able to:
• Explain the components of the global surgical package 
• Explain the differences between the CPT and Medicare guidelines for
surgical services 
• Explain the meaning of a separate procedure and its effect on
bundling of services. 
• Explain the Correct Coding Initiative and its effect on bundling of
services 
• Explain the special rules for reporting endoscopic and open
procedures 
• Explain correct reporting for lysis of adhesions 
• Report services when one physician does not perform all the
components of the surgical global package
 
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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