November 2015 Client Newsletter
ICD-10 Conversion Going Fine, Few Issues
Overall, the switch to ICD-10 seems to have gone smoothly. No significant issues have come up, although there are some minor issues with ambulance claims due to the new, more stringent Medicare LCD requirements, including the "Dual code." Documentation by EMT's in the run Report is critical to clearly know which Duel code the patient qualities for. Since we are certain there will be audits, we are being extra cautious when selecting. If the documentation is not present, the runs will be denied by Medicare.
Medicare isn't saying the patient(s) cannot be transported, they are simply deciding whether the patient's clinical picture meets their payment requirements. More in depth information has been sent to our ambulance clients.
CMS - Final Meaningful Use
Stage 2 Modifications and Stage 3 Rules
On October 7th, the CMS released the long-awaited final regulation that includes modifications to Stage 2 of the EHR Incentive (Meaningful Use) Program and outlines the requirements for Stage 3 of the program. The rule also specifies EHR certification standards and finalizes the government's "interoperability roadmap." For Meaningful Use in 2015 through 2017, major provisions include:
- Shortened 2015 reporting period (from all year to any 90 consecutive days in 2015);
- Ten objectives for eligible professionals including one public health reporting objective, down from 18 total objectives;
- Reduced number of measures that are required to be reported;
- Reduced measure threshold for View, Download or Transmit (from 5% tojust one patient in 2015); and
- Reduced measure threshold for Secure Messaging (from 5% to simply having the capability in 2015).
If you are interested in more details, you can find them in the CMS fact sheet.
Telemedicine: The Final Healthcare Frontier?
Telemedicine is now getting more interest and becoming more accepted as a way for patients to receive care sooner. Some states have addressed this new form of healthcare and others have not.
Regardless of where the provider is actually located (out-of-state), the provider must be licensed in the state where the patient resides. NJ S2729 is pending - so an out-of-state provider is not currently allowed to treat a patient residing in New Jersey. Nationally, an out-of-state provider is generally allowed to treat a patient located in a Rural Health Professions Shortage area (HPSA).
Providers not located in New Jersey, be sure to check with your state medical society or the state medical society in the state where a prospective patient lives before providing care to an out-of-state patient.