Brush up on major vaccination coding changes that took effect in 2011 to avoid denials this flu season, experts say. You must also remember to document counseling patients on vaccines, and note the differences between Medicare and private payer administration codes. On the private payer side, the CPT changes for administering the flu vaccine have increased revenue for vaccines with multiple components.

It won’t be hard for each of your physicians to choose a clinical decision support (CDS) rule – a patient-specific clinical note or reminder – but you must ensure they choose rules that will actually be useful without slowing workflow. What is a CDS rule? CDS rules are a feature of your electronic health record (EHR) designed to give physicians information on caring for a patient when a specific condition is triggered.

You and your peers aren’t happy with CMS’s latest revalidation cycle, which will require just about everyone to revalidate again by March 23, 2013 – but a major new feature could let you revalidate in minutes online. Practices that still prefer to do Medicare credentialing via the paper CMS-855 forms would finally run out of reasons to avoid the web-based Provider Enrollment Chain Ownership System (PECOS), experts say.

You and your peers stand to see several minor and a few big rate-slashing changes should every provision in CMS’s proposed 2012 Physician Fee Schedule (PFS) get finalized. But the AMA and Medical Group Management Association (MGMA) felt some key matters went unresolved, according to their official fee schedule comments released in early September.

You have less than 100 days left before payers automatically reject your claims that were sent electronically using the current HIPAA version 4010 standard. You must implement HIPAA 5010 and test claims with your payers by Jan. 1, 2012. There are a significant number of providers who have fallen behind on the testing timeline and are at serious risk of seeing payment delays for all payers come January, experts say.