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Find-A-Code Focus Newsletter

2015 January Articles


PQRS CMS.gov Interactive Timeline - Don't Miss the Deadlines!

January 30, 2015
Don't miss your deadlines! Keep up on PQRS reporting dates as well as Incentive Program deadlines. Visit CMS.gov Interactive Timeline.... Read More

CMS Opt-Out Regulations and Guidelines

January 30, 2015
40-Effect of Beneficiary Agreements Not to Use Medicare Coverage (Rev. 160, Issued: 10-26-12, Effective: 01-28-13, Implementation: 01-28-13) (Rev. 194, 09-03-14)   Normally physicians and practitioners are required to submit claims on behalf of beneficiaries for all items and services they... Read More

Value Set Authority Center (VSAC)

January 28, 2015
Per Centers for Medicare and Medicaid Services (CMS), VSAC is the official repository for Value Sets that support 2014 Meaningful Use Clinical Quality Measures (CQMs). VSAC will also host other value sets such as Routes of Administration and Patient Assessment Instruments in the... Read More

Underdosing - a New Clinical Concept in ICD-10 codes T36 - T50

January 28, 2015
T36-T50 Poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances (T36-T50) Underdosing is a clinical concept new to ICD-10. Underdosing identifies situations referring to the practice of a patient taking less medication as p... Read More

Medicare to Change How it Pays Doctors and Hospitals

January 27, 2015
The Obama administration outlined ambitious new goals Monday to transform over the next four years the way that the gargantuan Medicare program pays doctors and hospitals, rewarding providers that achieve better outcomes for patients rather than those that just do more. The move away from so-called... Read More

New: 2015 January Edition of the Medicare Quarterly Provider Compliance Newsletter

January 23, 2015
Find-A-Code has posted the January 2015 edition of the Medicare Quarterly Provider Compliance Newsletter at: http://www.findacode.com/medicare/medicare-quarterly-provider-compliance-newsletter.html Topics include: Office of the Inspector General (OIG) Report Finding: Hospitals Receiving Overpay... Read More

Eligible Professional 2014 Attestation Deadline on February 28; Prepare for Attestation

January 23, 2015
If you are an eligible professional participating in the Medicare EHR Incentive Program, you have until February 28, 2015 to attest to demonstrating meaningful use of the data collected during your EHR reporting period for the 2014 calendar year. If you are participating in the Medicaid EH... Read More

Billing for Split Unit of Blood

January 14, 2015
Billing for Split Unit of Blood (Rev. 1487, Issued: 04-08-08, Effective: 04-01-08, implementation: 04-07-08) HCPCS code P9011 was created to identify situations where one unit of blood or a blood product is split, and some portion of the unit is transfused to one patient while the o... Read More

Aligning the Way Providers are Paid to Reward Value Rather than Volume (Value Based Modifiers)

January 14, 2015
CMS is aligning the way providers are paid to reward value rather than volume. Paying providers for quality, not quantity of care. In 2015, Medicare is continuing to phase in the Value-based Payment Modifier, which adjusts traditional Medicare payments to physicians and other eligible p... Read More

What is an LMRP and Where Can I Find Them?

January 14, 2015
Local Medical Review Policies (LMRPs) were converted to LCDs. This was done as a result of the Benefits Improvement and Protection Act of 2000 (BIPA 2000). The difference between LCDs and previously written LMRPs is that LCDs contain only reasonable and necess... Read More

Holding of 2015 Date-of-Service Claims for Services Paid Under the 2015 Medicare Physician Fee Schedule

January 06, 2015
On November 13, 2014, the CY 2015 Medicare Physician Fee Schedule (MPFS) final rule was published in the Federal Register. In order to implement corrections to technical errors discovered after publication of the MPFS rule and process claims correctly, Medicare Administrative Contractors w... Read More

Modifier -59 Could Impact Your Reimbursement - New Coding Requirements!

January 06, 2015
Centers for Medicare & Medicaid Services (CMS) is establishing four new HCPCS modifiers to define subsets of the -59 modifier, a modifier used to define a “Distinct Procedural Service.” Be sure your billing staff is aware of the modifier changes! The primary issue associated with t... Read More

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