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09/16/2010

This week's question is answered by Regan Bode, CPC, CPC-H, CPMA, CEMC, ACS-EM, content manager for DecisionHealth and consultant for DecisionHealth Professional Services.

Q. Two of our major payers - one of which is Medicare and the other is Healthpoint, the distributor for OASIS - disagree on the right CPT codes our physicians should use for the application of the product. Healthpoint suggests codes 15430-15431 (apply acellular xenograft) would be appropriate. Who's right?

09/16/2010

You'll need seven components - whether they're contained within one electronic health record (EHR) system or spread out in modules from different vendors - to meet stage 1 meaningful use criteria, experts say. This concise illustration shows which functions and capabilities are performed by each component, as well as how they work together.

09/16/2010

Summary: Do some states or regions tend to bill more imaging services to Medicare than others? This chart looks at state-level utilization of common imaging services based on the latest CMS claims data, from 2008. To account for differences in state populations, the chart measures number of imaging services billed per single enrollee.

09/16/2010

Starting in 2011, CMS will waive the copay for the scantly utilized abdominal aortic aneurysm (AAA) screening, removing an obstacle to the service and, in the process, potentially creating a new revenue opportunity for your practice. However, the service isn't open to everyone and you must meet requirements to bill the service G0389 (ultrasound exam, AAA screen, $108.78).

09/16/2010

The swine flu/H1N1 scare is over and you won't be separately billing for swine flu during the 2010-2011 flu season. The seasonal flu vaccines you administer to your patients this flu season will have strains of the H1N1 virus included. "There is no longer a pandemic but it's in there," says Cynthia Hughes, CPC, the American Academy of Family Physicians' (AAFP) coding and compliance specialist.

09/16/2010

Uninsured and underinsured patients are flocking to discount health plan programs to obtain medical services at a discount. These programs, known as discount medical card programs or referral plans, aren't illegal. But they're not actual insurance plans and can create problems for you when patients have an inflated sense of their own coverage.

09/16/2010

You and your peers electronically prescribing controlled substances to patients can count these encounters toward earning a bonus from CMS's Electronic Prescribing (e-prescribing) Incentive Program, CMS says. The encounters also will count toward thwarting e-prescribing penalties in future years.

09/16/2010

First of a two-part series. You must use a "certified" electronic health record (EHR) system for a shot at up to $44,000 in per-provider federal bonuses, but that doesn't mean you have to sink a massive upfront sum into a new, off-the-shelf package, experts say.

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