CPT changes go into effect on 1/1/2018. A few highlights for frequently used categories are noted below. Please refer to the spreadsheet link here to review all code additions, deletions and revisions. The spreadsheet includes a summary tab and additional tabs separated by specialty. For ease of review, the code change category is noted in Column A. Radiology CPT codes 71010-71035 for x-ray of chest are being deleted and replaced with the following four CPT codes and...

Closure of NOPR (NaF-PET) on December 14, 2017  On December 15, 2015, The Centers for Medicare & Medicaid Services (CMS) issued a final decision memorandum http://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=279 pertaining to the coverage of bone PET with F-18 sodium fluoride (NaF-PET) to identify bone metastasis. This National Coverage Decision (NCD) extended the requirement for coverage with evidence development (CED) under §1862(a)(1)(E) of the Social Security Act for NaF-18 PET to identify bone metastasis of cancer contained in section 220.6.19B of the...

Some Important Changes It is that time of year when we are all awaiting colder weather and anticipating the release of the final rule for CY 2018 PFS! CMS finalized revisions to payment policies under the physician fee schedule along with other revisions to Part B for the calendar year of 2018. The 2018 final rule is scheduled for publication in the Federal Register on November 16, 2017.  Below you will find some highlights to some...

The wait is over! The final rule with comment period is to be published November 16, 2017! There are some changes to reporting period 2018 (year 2), but many flexibilities will remain the same as CMS wishes to proceed slowly to prepare clinicians for full implementation in year 3. Below are some highlights to the 2018 final rule as it pertains to the Quality Payment Program. This is not an all-inclusive list and Meridian Medical Management...

Information you’ll need to know regarding program year 2017 Modified Stage 2: You must attest for program year 2017 no later than midnight on March 31, 2018 All eligible professionals (EPs) must attest using EHR technology certified for 2014 or 2015 or a combination of both All providers are required to attest to a single set of ten objective and measures The EHR reporting period for Meaningful Use and Clinical Quality Measures (CQMs) is 90...

The 2017/2018 Influenza Season is starting! Are you ready to code accurately to be reimbursed correctly? According to the Center of Disease Control and Prevention, receiving an annual flu vaccine is the greatest method in protecting yourself and those around you from the flu. The more people who are vaccinated the more people will be protected. Who should be vaccinated? All persons should receive the flu vaccine but the following groups are at high risk: Older people and those...

As previously communicated in Meridian Medical Management Provider News and Alerts, posted and distributed to all clients on July 28, 2017, the new 2018 ICD-10-CM codes are to be used for discharges and patient encounters occurring from October 1, 2017 through September 30, 2018. These files were released in June 2017 and can be accessed at the Centers for Medicare & Medicaid Services (CMS) website and include the 2018 Code Descriptors in Tabular Order, 2018...

On June 30, 2017, the State of Connecticut approved a bill requiring Electronic Prescribing of Controlled Substances (EPCS), which will go into effect January 1, 2018. This was enacted as part of Connecticut’s measures to prevent prescription opioid diversion and abuse. Full details of the bill can be found at the official site of the Connecticut General Assembly. To meet CT State requirements, all Meridian Medical Management clients using e-Prescribing through the VertexDr EHR will need...

The Centers for Medicare & Medicaid Services (CMS) published the CY 2018 PFS proposed rule on July 21, 2017. This proposed rule includes proposals to update payment policies, payment rates, and quality provisions for services furnished under the Medicare PFS on or after January 1, 2018. Under the PFS, payments include services provided by physicians and other practitioners in all sites of service. Some of these services include but are not limited to visits, surgical...

CMS has made available the updated ICD-10-CM and ICD-10-PCS Code lists for 2018. These codes take effect on October 1, 2017. This summary identifies the new codes added, any revised codes, and the deleted codes. The link following this summary document will provide you with the new, revised, or deleted codes by specialty. Reminder: ICD-10 requires health professionals to code to the highest degree of specificity. SUMMARY OF CHANGES IN TOTAL: NEW CODES ADDED – 360 ...