Tag Archives | Npi

EHR Incentive Program Enrollment Starts Soon

CMS clears up flu shot coding confusion.

You’ve heard the advantages of participating in CMS’s Electronic Health Record (EHR) Incentive Program (including $44,000 per-physician bonus incentives over a five-year period), but you may not be sure how to enroll.

CMS staffers cleared up that confusion during an Oct. 5 open door forum, where CMS’s Rachel Maisler indicated that you must register on CMS’s EHR incentive program’s Web site, which will open in January 2011 for the Medicare program.

In addition, you must be enrolled in CMS’s PECOS system and have an NPI, and you must use certified EHR technology. You can find details on how to determine which EHR systems are certified on www.healthit.hhs.gov.

Key dates: During the call, CMS reps also announced important dates involved in EHR participation. “Attestation, which is how you will report the objectives and measures for meaningful use and clinical quality measures, will begin in April of 2011, and we expect the first payments will be made in May of 2011,” Maisler said.

Look for Combined Flu Shot

Flu vaccine: Now that the H1N1 immunization is part of the regular flu vaccine, a caller asked the CMS officials whether a new code will be developed to describe the combined flu shot, but CMS officials noted that no such code will be issued.

“We’re continuing to use the same codes as last year, and my understanding is the H1N1 is part of the regular flu vaccine this year, so you’d bill what the appropriate flu vaccine code is,” said CMS’s Amy Bassano, during the call. High-dose flu vaccine code 90662 (Influenza virus vaccine, split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use) has been added to the roster of codes that can be billed to Medicare, Bassano confirmed.

RACs: Another caller…

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Append Modifier Q6 for Fill-In Physician

Before using modifier Q6 for a non-Medicare patient, check with the commercial payer — here’s why.

Question: We hired a locum tenens for two weeks. Do we code the same for the replacement physician as for a full-time

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CMS Delays Ordering/Referring PECOS Regulation Until 2011

Take the extra time to get your practice registered in PECOS — don’t wait until the end of the year, CMS reps say.
Practices that were busily struggling to find out whether their ordering/referring physicians’ national provider identifiers (NPIs) were in the PECOS system can relax a little bit — at least until next year.
If your physician performs […]

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  1. CMS: Billing Co. Can’t Fill Out PECOS Form on Doc’s BehalfIf you’ve grown accustomed to a designated credentialing specialist in…
  2. A Press Release Is Not a Legal Ruling, PECOS Pundits Point OutKeep an eye on the Federal Register as you use…
  3. CMS Changes Course: Physicians Need Not Personally Complete PECOS ApplicationWhat a difference three months makes, especially when it comes…
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Service Doesn’t Meet Incident-To Rules? Report Under NPP’s NPI

Heads up: These vaccine admin codes are excluded from incident-to requirements.
Incident-to rules don’t always apply to diagnostic services, but many medical practices aren’t aware of that.
And based on a new wave of scrutiny directed toward incident-to claims, you should know physician supervision rules inside and out.
A recent audit from the HHS Office of the Inspector […]

Related articles:

  1. Nonphysician Providers and Incident-To: Your Coding Questions AnsweredHere’s why you should keep your physicians’ work schedules on…
  2. Use This Incident-To Checklist to Breathe Easy During an Audit You don’t need to second-guess the way you bill…
  3. 5 Rules Pinpoint Date of Service for Laboratory ClaimsTip 3: Here’s DOS advice for archived samples. You can’t…
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