Endonomics™ is an e-newsletter from the Socioeconomics & Member Advocacy Office of the American Association of Clinical Endocrinologists (AACE).
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Do you know the purpose of the CERT contractor?
The CERT contractor checks to see that providers are billing correctly and contractors are paying correctly. They select and review claims, assign improper payment categories, calculate improper payment rates and provide education to change behaviors.
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What is HPID?
It's a Health Plan Identifier and is a standard, unique health plan identifier required by HIPAA. All controlling health plans, except small plans, were required to obtain HPIDs by Nov. 5, 2014.
Click here for more information.
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Endonomics™ is distributed free to both AACE members and non-members. The goal is to provide the latest industry news to those who work in the business side of an endocrinology practice.
Be Part of the Network
To be added to the distribution list, email your name, title, name of practice/business, phone and fax, and preferred email to: Endonomics@aace.com.
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Visit AACE's
EmPower
Magazine's
website
for endocrine patient information.
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Dear Practice Support Subscriber,
Welcome to another edition of
Endonomics™ ,
an
e-newsletter for physicians, practice management specialists, office administrators, coders, billers, collectors and other endocrinology business office staff.
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Get in the Know. . .
Cultural Competency and Health Care Disparities Resources for Physicians and Patients
Did you know that the AACE website provides a centralized venue for physicians and patients with helpful information on culturally competent care and health care disparities and endocrine disorders?
The AACE Underserved Populations Committee maintains the Cultural Competency and Health Care Disparities Resources webpage in an effort to help members deliver culturally effective health care and enhance the resources available regarding these issues for their patients.
Resources include articles and reports such as dietary information during fasting and downloadable materials in various languages, as well as information about cross cultural courses.
Click here to access the website and click here to access the Cultural Competency an Health Care Disparities resource material.
Also, encourage your patients to the AACE Patient Portal -- EmPower Your Health, by selecting the 'Patients' button at the top of the website, which includes information on AACE programs and other materials.
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Physician Quality Reporting System (PQRS)
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* EHRs Incentive Programs must meet the Clinical Decision Support (CDS) Object. The CDS is not simply an alert, notification, or explicit care suggestion. Providers can meet the objective by using other kinds of CDS, including but not limited to clinical guidelines.
Click here for more information and FAQs.
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T he Medicare EHR Incentive Program Hardship Application Deadline for All Providers is Now
July 1.
The new applications and instructions for providers seeking a hardship exception are available here.
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 The Centers for Medicare & Medicaid Services (CMS) announced a proposed rule to test new models to improve how Medicare Part B pays for prescription drugs and supports physicians and other clinicians in delivering higher quality care.
Click here to read more including a Fact Sheet.
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Medicare's Quarterly Provider Updates 2016
Please alert your coding, billing and collection staff.
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Click here
for the ICD-10-CM Diagnosis Codes for Bone Mass Measurement SE1525. Please alert your coding and billing staffs.
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Comments Welcomed
CMS has invited the public to comment on the recently released Notice of Proposed Rulemaking (NPRM), which implements key provisions of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) through the unified framework of the Quality Payment Program.
Click here
to learn more about MACRA and to submit your comments.
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Click here for the April 2016 Outpatient PPS Pricer file.
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Click here for the 2016 ASP Drug Pricing files updates.
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Click here for information on how to appropriately code for drugs discarded/not administered. Please share with your coding and billing staffs.
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Click here for FAQs about billing the physician fee schedule for Advanced Care Planning Services.
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CMS released the
Next Steps Toolkit to help providers track and improve ICD-10 progress. This new, in-depth toolkit includes information and resources on how to:
* Assess ICD-10 progress using key performance indicators to identify potential productivity or cash flow issues.
* Address opportunities for improvement
* Maintain progress and keep up-to-date on ICD-10
In the coming weeks, CMS will also release a companion infographic with simple steps from the Next Steps Toolkit. More information will follow.
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Stay Up-to-Date on ICD-10
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CODING ALERT
CMS' National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits will not allow CPT® codes 76942 (ultrasound guidance) and 76536 (diagnostic head and neck ultrasound) to be billed on the same date of service. Please be aware that some commercial carriers may also follow these NCCI/PTP edits.
Please alert the appropriate coding, billing and practice management staff of the most recent
NCCI edits manual which became effective January 2016 and the
HCPCs codes which became effective April 2016.
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Practice Management Information
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In response to concerns raised by the AMA and others, CMS today issued a small practice fact sheet that outlines aspects of the proposed MACRA regulation that were intended to address the needs of smaller physician practices. In particular, the document explains that the rather alarming impact table projecting a disproportionately severe impact on solo physicians and small groups is based on misleading data.
AMA staff are working to identify refinements that could be made to the proposed rule to provide further relief and assistance to smaller practices. Those will be included in our formal comments that will be submitted to CMS in late June. We have also updated the MACRA proposed rule summary that was distributed earlier. Click here to access the most recent version.
Click here
to read the Small Practices Fact Sheet.
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Practice Management/HIPAA/Compliance
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SURVEY
The Healthcare Administrative Technology Association, the national association of Practice Management systems collaborating to influence positive change in the industry, would like to invite you to participate in a short survey to provide critical information regarding the major pain points that still exist with electronic eligibility.
Your feedback will be used to develop recommendations that will be presented to industry decision makers with one representative voice and a collective strength that will encourage outcomes allowing you to continue delivering the best patient care. Click here to take the survey which will be open for responses through Tuesday, May 31.
Thank you for your time and collaboration on this important initiative. Please share with your Practice Management staff.
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Are you familiar with taxonomy codes? Incorrect taxonomy codes can cost you money.
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Click here for the April 2016 UnitedHealthCare Network Bulletin.
Click here for information on Genzyme's Financial Assistance Program offer for Thyrogen.
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Registration Now Open for Endocrine Coding Courses
Courses are designed for physicians, non-physician practitioners and staff.
Boston, MA
June 10: Bridge the Gaps in Endocrine Coding
June 11: AACE Your E/M Coding
St. Paul, MN
July 11: Coding Essentials for Endocrinology
July 12: AACE Your E/M Coding
San Antonio, TX
October 20: Bridge the Gaps in Endocrine Coding
October 21: AACE Your E/M Coding
Atlanta, GA
November 14: Coding Essentials for Endocrinology
November 15: AACE Your E/M Coding
Click here for more information or to send questions to
Space is limited. Don't delay. Register today.
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Join AACE's free Practice Support Network and receive bimonthly editions of
Endonomics
™ -- A Practice Management newsletter for the business side of your office. Send your name, address, phone, fax and email address to:
endocoding@aace.com
and become part of the network today.
Click here
for more information on
Endonomics
™ and see the latest editions.
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All medical coding must be supported with documentation and medical necessity. **While this document represents our best efforts to provide accurate information and useful advice, we cannot guarantee that third-party payers will recognize and accept the coding and documentation recommendations. As CPT®, ICD-10-CM and HCPCS codes change annually, you should reference the current CPT®, ICD-10-CM and HCPCS manuals and follow the "Documentation Guidelines for Evaluation and Management Services" for the most detailed and up-to-date information. This information is taken from publicly available sources. The American Association of Clinical Endocrinologists cannot guarantee reimbursement for services as an outcome of the information and/or data used and disclaims any responsibility for denial of reimbursement. This information is intended for informational purposes only and should not be deemed as legal advice, which should be obtained from competent local counsel. Current Procedural Terminology (CPT©) is copyright and trademark of the 2016 American Medical Association (AMA). All Rights Reserved. No fee schedules, basic units, relative values, or related listings are included in CPT©. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply to government use.
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Copyright © 2016. All Rights Reserved.
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