News
Economic Impacts of Private Practice Physicians in Bronx County, New York
Bronx County Brochure "Economic Impact Study"
3rd Annual Legislative Health Forum
Thursday - February 18, 2009
Agenda & Additional Information
Registration Form
Billing Medicare for Consultations Codes
January 12, 2010
Medicare is no longer accepting office consultations codes (99241-99245) or hospital consultations codes (99251-99255), as of January 1, 2010. Why? Well, the Office of Inspector General estimates that approximately 75% of consultations billed to Medicare were incorrect;specifically, 47% of consultation billing to Medicare involved wrong type or level of service, 19% did not meet definition of consult and 9% lacked appropriate documentation. Also, OIG audits have uncovered that in 2006 overpayments for consultations by the Medicare program amounted to approximately $1.1 billion in 2001.
Instead, “consultation” services will fall under the following codes, depending on the services rendered:
Office Visits ( New patient or established)
99201-99205 or 99212 - 99215
Initial Hospital Visits ( Admit or subsequent care)
99221- 99223 with modifier (AI) or 99231-99233
**Note: the AI modifier = admitting provider only
I’ve asked our friend Louis at E Central Medical Management to provide suggestions for practices in response to the Medicare changes and he offered.
1. In addition to being educated about the new changes, all practices should adopt new charge slips or superbills that reflect the Medicare changes. A professional should be consulted to help the practice accomplish this because all future billing will be based on the new charge slips and/or superbills and they must be correct.
2. Because the old codes do not simply translate over to the newly designated codes (i.e., a 99254 doesn’t necessarily equal a 99222), practice administrative staff or even a professional biller or coder should not select new code designations without the input of the doctor performing those services.
3. Be sure that all codes are substantiated by documentation because where coding changes happen, audits are bound to follow.
Contact Louis with any questions regarding the new Medicare codes and for assistance with creating new charge slips and/or superbills at 718.525.8567 or louisb@ecmmgt.com. E Central Medical Management regularly provides consultation services for healthcare practitioners for all practice billing issues.
Note: the above change only applies to Medicare for now. All practices should continue to bill commercial carriers for consults, medical clearances and follow consultation documentation guidelines for both commercial payors and Medicare.
For additional information on this topic, contact Jennifer Kirschenbaum at (516) 747-6700 ext. 208 or at Jennifer@Kirschenbaumesq.com. Click here to access prior healthcare email newsletters or articles.
COMPLIANCE PROGRAM
Click here for required policies and procedures: (i) Compliance Plan (that includes your Committment to Compliance, Designation of Privacy Officer, Training and Education, Potential Risk Areas, Reporting, Auditing and Monitoring, Corrective Action Policies and Procedures); (ii) HIPAA, Red Flags Rule and Security Policies; (iii) Employee Manual; and (iv) Misconduct Pledge. The Compliance Plan complies with OIG specifications for individual and small group practices. All HIPAA and Security policies include modifications pursuant to HITECH Act. www.kirschenbaumesq.com/healthcareorder.htm.
The Center to Promote Health Care Studies, Inc.
SEMINAR NOTICE:
New York State Mandated Infection Control Course for all doctors and nurses, interns, residents, optometrists, podiatrists, dentists, and dental hygienists.
NEW YORK CITY’S ONLY PUBLIC, LIVE, MANDATED SEMINAR FOR INFECTION CONTROL. NO EXAM.
$60 in advance tuition includes: danish, coffee & seminar workbook ($75 at the door)
Faculty: Janet Eagan, Director of Infection Control, Memorial Hospital for Cancer & Allied Diseases
Saturday mornings: January 23, March 6, April 17
Time: 8:45 - 10:30a.m. (sign in, danish & coffee at 8:30a.m.)
NO EXAM
Course Approved by New York State Department of Health
Location: Dewitt Nursing Home
211 East 79th St.
Between 2nd & 3rd Ave., New York, NY 10021
(212) 879-1600
*Three blocks from the Lexington Avenue # 6 IRT 77th St. Subway Station
To Register: Call (800) 689-8459 or
Fax Registration Form to (914) 725-6489
Email: info@centerfortraining.com
Mail: Full Tuition and Registration Form to: The Center to Promote Health Care Studies, Inc., 14 Colvin Road, Scarsdale, NY 10583
Click here to download the Infection Control Registration Form
6th Walk-A-Thon
- Doctor's For A Healthier Bronx
Automatic Medicaid Crossover
Medicaid to Implement Automated Medicare Crossover in December 2009
Clinical Nutrition Meeting sponsored by the NY Academy of Medicine November 5th.
Important Educational Opportunity for Nutrition Researchers and Clinicians
RED FLAG RULES
Identity Theft Prevention Program
Physician Legal Alert
What Health Care Providers Need to Know
Pathmark Event
Click image to enlarge
FREE AIR CONDITIONERS FOR HIGH RISK POPULATION
2009 Heat Heatlth Update
Heat Illness Information for Providers
Membership News - Regarding Medicare Contractor Listservs
CMS Learn Resource: 200906-02
Help your association members stay up-to-date on the latest Medicare-related information! Below is a brief news item that we encourage you to put in your next newsletter, bulletin, or whatever vehicle you use to provide your members with news they need to know. Through their electronic mailing lists, Medicare contractors serve as a valuable source of news and information regarding Medicare business in specific provider practice locations, including local coverage determinations and local provider education events. So do your members a favor and help us spread the word!
“Did you know that your local Medicare contractor is a valuable source of news and information regarding Medicare business in your specific practice location? Through their electronic mailing lists, your local contractor can quickly provide you with information pertinent to your geographic area, such as local coverage determinations, local provider education activities, etc. If you have not done so already, you should go to your local contractor Web site and sign up for their listserv or e-mailing list. Many contractors have links on their home page to take you to their registration page to subscribe to their listserv. If you do not see a link on the homepage, just search their site for “Listserv” or “e-mail list” to find the registration page.
If you do not know the Web address of your contractor’s homepage, it is available at www.cms.hhs.gov/MLNProducts/downloads/CallCenterTollNumDirectory.zip on the CMS Web site.”
New York State Workers' Compensation
The New York State Workers' Compensation Board recently issued a reminder for providers about changes in forms taking effect on
April 1, 2009.
http://www.wcb.state.ny.us/content/main/SubjectNos/sn046_301.jsp.
See attached file: SN046-301.pdf
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The Inaugural Ceremony for the 13th Borough President
The Honorable Ruben Diaz, Jr.
BCMS 2nd Annual Legislative Forum
February 19, 2009 - Maestro’s Caterers
This open forum with local community leaders & our legislative representatives took place on Thursday, February 19. The Forum was well planned and orchestrated thanks to the efforts of
Drs. Izquierdo, Diaz, Rana & Pathy.
We thank the discussion leaders:
Rick Abrams, EVP of MSSNY
Jitendra Barmecha, MD & Gerald Conway, Esq.
Event Sponsored in part by: Nick Lugo, Publisher
LA VOZ HISPANA
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