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...

Claudia Maiorana, Director - Account Management How many different journeys is your organization taking to get to what you think is a shared destination? People within organizations are frequently travelling different paths – certain they are working towards the same goal, but when asked, that is often not the case. Aligning team members to meet the organization’s most important goals is an active process that requires lean thinking. Sometimes associated with manufacturing, most notably Toyota, lean processes...

Dan Reber, VP of Product Strategy and Development, PrecisionBI Earlier, we talked about the four pillars that serve as cornerstones for successful business intelligence (BI) initiatives: Self-Service, Collaborative, Enterprise and Automated. To fully appreciate how they work together, it is important to understand how each one functions and its role. We will start with Self-Service BI. Self-Service BI helps people get the information they need, turning raw data into actionable insights. Simply put, it enables non-technical people...

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 ...

Jonathan Sharr, Senior Decision Support Analyst, Middlesex Hospital A community hospital based in Middletown, Conn., Middlesex Hospital strives to provide the safest, highest-quality healthcare, and the best experience possible for our community. Our position as the state’s first Mayo Clinic Care Network member demonstrates our commitment to improving care through innovation and collaboration. To do that, we need actionable data not just within the hospital, but also across our physician practices. Multiple disparate systems complicate the...

The proposed rule for the Physician Fee Schedule (PFS) for calendar year 2018 is scheduled to be published on July 21, 2017. Within this proposal is additional information regarding the Appropriate Use Criteria (AUC) for advanced Imaging services. Evidence-based AUC for advanced imaging will assist clinicians in selecting the imaging study that is most likely to improve health outcomes for patients based on their individual clinical presentation. CMS defined qualified Clinical Decision Support Mechanisms (CDSM) as...

L. Albert Villarin, MD, FACEP Information is critical to delivering care and dozens of decisions per day are based on the what data is available at that time. Several industries, including travel and automotive, have been years ahead of healthcare in incorporating technology to gain insight and guide decisions. When you check into a hotel, they seem to know you and your preferences, including when you last stayed with them, if you prefer a higher floor...

The 2018 proposed rule for the quality payment program (QPP) is scheduled to be published on 06/30/2017. This new program went into effect 1/1/2017 known as the transition year.  The goals of the program are to improve health outcomes of Medicare beneficiaries, spend more wisely, minimize the burden to participate and become more transparent. Below is a summary of the 2018 proposed rule related to the 4 categories included under the Merit-Based Incentive Payment System (MIPS): ...