Blogs

Maria Bounos from WKLB to co-host ICD10monitor’s Talk Ten Tuesday

News Flash - On Tuesday, March 19, 2013, Maria Bounos, Practice Leader from Wolters Kluwer Law & Business, will be co-hosting ICD10monitor’s Talk Ten Tuesday with the infamous Chuck Buck! The subject for this live weekly podcast is: Why ICD-9 Cannot Support Better Healthcare in America.

2013 Physician Fee Schedule impacted by the American Taxpayer Relief Act of 2012

In response to the passage of the American Taxpayer Relief Act of 2012, CMS has published a revision to the RVU file for January 2013.  The Conversion Factor used to calculate payment was shifted from $25.0008 (reported in the original 01/2013 RVU13A file) to $34.023 (in the replacement RVU13AR file).  The conversion factor used in 2012 was $34.0376.

In addition, CMS has made multiple corrections to other variables, including relative value units for many codes. If you would like to investigate the payment differences, here are several tools to help:

2013 Physician Quality Reporting Initiative Measures

CMS has issued the 2013 PQRI Specifications Manual for Claims and Registry (v 7.2).  This identifies the 202 measures for 2013. 

This resource is available as a browseable e-book in the Coding Suite products Coding & Revenue Resource Center (CRRC) and Audit & Revenue Resource Center (ARRC).  The manual can be found in the CMS - Coding Guidance library under the Quality heading, and will automatically be searched when you click on the Guidance link from the Advanced Code Explorer screen.

Each measure section includes:

2013 CPT Changes Overview (Webinar Replay)

Click here to see a replay of the 2013 CPT Changes Overview webinar.

This webinar will give you a better understanding of 2013 CPT changes, on this program we will cover the following topics:

 

  • Overview of changes in CPT for 2013
  • Review of each CPT change by section of CPT to include:

o Anesthesia
o Surgery
o Radiology
o Pathology/Laboratory
o Medicine and Category II & III codes

National Coverage Determinations and Consent to Treatment: An Enterprise Risk (Webinar Replay)

Click here to see a replay of the National Coverage Determinations and Consent to Treatment: An Enterprise Risk webinar. This presentation will examine the enterprise risk management (ERM) exposures stemming from the “three wrongs” NCDs. The featured speaker will discuss the importance of consent to treatment as a key ERM tool, along with other strategies to mitigate liability and exposure to compliance risks.

Objectives:

Survival Strategies and the OCR Audit Process

Click here to see a replay of the "Are You Audit Ready? Survival Strategies and the OCR Audit Process" webinar. This webinar provides guidance on how to plan and implement an audit-readiness process, including setting priorities, determining what to do with your risk analysis results, preparing your policy and documentation requirements, and assuring awareness among your organization’s leaders and management.  The discussion includes the use of tools to assist in preparatio

Laboratory Services: Preserving a Healthy Revenue Stream (Webinar Replay)

Click here to see a replay of the Laboratory Services: Preserving a Healthy Revenue Stream webinar. This webinar will help you void costly denials of payment for laboratory services by expanding your knowledge of CMS rules and guidelines for frequently ordered laboratory tests.

Confused by NCCI Edits?

A smart customer reached out with a question about what looked like a conflict - that a modifier was allowed in one setting but not another for the same two codes. While this is common (NCCI has 2 versions - Hospital and Physician), the investigation lead to a great example that illustrates an important issue with how CMS can introduce retroactive changes.

Physician NCCI

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