Greetings to all of our Azalea Health Innovations friends and thank you for reading this month’s newsletter. AHI has exciting news, we have been named as one of 75 small businesses, nationwide to receive the Blue Ribbon Small Business Award from the U.S. Chamber of Commerce. Additionally, we will be competing against other Blue Ribbon winners for the Community Excellence Award. This is where we need your help! Please take a few moments to vote for us!
Also, March is National Nutrition Month, so be sure to make informed choices for your daily meals. For more information on how to make the best choices for you and your family, go to the Academy of Nutrition and Dietetics website.
Major Progress in Doctors and Hospital use of Health Information Technology
According to the U.S. Department of Health and Human Services’ Secretary Kathleen Sebelius, the amount of hospitals using health information technology (HIT) has more than doubled in the last two years. This massive increase has allowed over 41,000 healthcare providers to receive a total of $3.12 billion in incentive payments from the Centers for Medicare & Medicaid Services (CMS). Alongside the health IT adoption comes the need for more health IT workers. According to the Bureau of Labor Statistics, “the number of health IT jobs across the country is expected to increase by 20 percent from 2008 to 2018”. To aid the healthcare industry in having enough workers to fill these positions, the Obama Administration has funded four training programs that specialize in health IT fields. In total, over 19,000 students have already enrolled into the four programs.
For the full article go to U.S. Department of Health & Human Services’ website.
Billing Tip: Coding Guidance for Use of Modifier 22
When a physician spends a substantial amount of time that is more than a common service usually requires, the physician can add modifier 22 to the usual procedure code to exhibit the extra time taken to complete the service. The provider must also provide documentation that supports the additional work and the reason for said work. Adding modifier 22 to a procedure code will often increase the reimbursement the physician receives for that procedure. Physicians often lose out on a considerable amount of money for lack of usage of modifier 22.
Modifier 22 should only be used when the work administered requires a significant amount more of the physician’s technical skills in the areas of work, time, and/or complexity than is usual.
Modifier 22 is appropriate to use in the following procedural cases:
• Trauma extensive enough to complicate the particular procedure and that cannot be billed
with additional procedure codes
• Significant scarring requiring extra time and work
• Extra work resulting from morbid obesity or other unusual anatomic anomalies
• Increased time resulting from extra work by the physician
• Additional work and time involved in managing a patient’s co-morbid conditions throughout
• When work associated with bundled procedures is more extensive than normal
It is important that the physician point out that the service performed required a more complex work load than commonly associated with the given procedure or include modifier 22. The documentation should also detail the extra effort or “additional not-separately-codeable services that were required to treat the patient”.
• It is not sufficient to simply state that the procedure is a re-operation or a revision of a previous procedure.
• It is not sufficient to simply document the extent of the patient’s illness or co-morbid conditions that might cause additional work. The documentation must describe additional work performed.
• It is not sufficient to state the specific skills and credentials of the provider that might make them uniquely qualified to perform the service. Modifier 22 is not appropriate unless the work involved substantially exceeds the work described by the CPT code for the service.
• It is not sufficient to add a paragraph describing extra time if the body of the report does not also describe the extra work.
• It is not sufficient to identify a new operative technique or new operative tool without also
identifying the additional work and time involved in its use.
Though documentation of modifier 22 can be found anywhere in the operative note, best practice is to add a separate statement containing the supporting information explaining the additional time or complexity of the case. The Guidelines to the CPT Surgery Chapter now include instructions for “Special Report” cases.
For the full article go to University of Washington Physicians.
Moving ahead with Stage 2 Meaningful Use
Stage 2: Where are you?
Initial requirements for Stage 2 were expected to be released by the Centers for Medicare & Medicaid Services (CMS) at the end of December 2011, but have yet to be announced. What types of requirements will be included in the much anticipated Stage 2? So far it appears that all of the requirements that were optional in Stage 1 will become core requirements in Stage 2. CMS has released information on what menu requirements have been chosen by early adopters and what menu requirements have been deferred by early adopters that have already attested for Stage 1. Since these early adopters are already ahead of their peers in attestation, they are likely to also lead them in terms of electronic health record (EHR) use and the menu requirements they chose to defer likely indicate what will be challenging for others.
What can we learn from early attesters?
The nation is viewing HITECH as a “real” program. As of the end of December in 2011 around 3,077 hospitals and 172,972 eligible providers (EPs) had registered for the incentive program. According to the Computer Science Corporation (CSC),”this represents 61% of eligible hospitals and 33% of EPs”. Since providers only register when they are ready to attest to receive payments, this number is expected to increase as more take advantage of the program in the future.
Where are the challenges with Stage 1?
In Stage 1, hospitals and EPs had core (required) requirements and menu (optional) requirements from which the organization needed to meet defined thresholds of use for a minimum number and could defer the rest. In Stage 2, it is likely that all items will be required. When healthcare providers were asked what areas they believed would be challenging to their organization, a number chose areas that were related to both care coordination and patient engagement. The areas of care coordination and patient engagement are exactly what will be required to meet the requirements of accountable care.
What will be the biggest challenges in achieving Meaningful Use for Stage 2?
Of the providers that were asked, only a small percentage said they were prepared to allow their patients to view and download their information either through a patient portal or directly through their EHR.
Recommendations for Stage 2:
Stage 2 is approaching fast. Don’t wait until the last minute to start the preparation for its arrival!
Three essential areas where organizations need to start now are:
1. Providing patients with access to their health information electronically through patient portals or directly from EHR systems.
2. Electronic capture of physician notes, including diagnosis and treatment, plus rationale for excluding patients from treatment recommendations.
3. Exchange of patient information at transitions in care.
For the full article go to Computer Sciences Corporation.
- AHI’s new speech recognition is featured as one of the 14 Most Interesting Health IT Products and Services that will be displayed at the HIMSS conference in Las Vegas.
- AHI has been named as one of seventy-five winners nationwide for the 2012 Blue Ribbon Award by the U.S. Chamber of Commerce and is also eligible to win the Community Excellence Award that will be chosen by public online voting. To vote for Azalea Health Innovations click here.
AHI will be exhibiting at the GPT- Georgia Partnership For Telehealth Annual Spring Conference. The event is being held at the Ritz-Carlton Reynolds Plantation in Lake Oconee, GA on March 14-16, 2012.
AHI will be exhibiting at the National Association of Rural Health’s Spring Institute on March 19-20, 2012. This event will be held in San Antonio, Texas.
AHI will be exhibiting Azalea Labhub℠ at the CLMA ThinkLab’12 – Clinical Laboratory Management Association. The event is being held at the Georgia World Congress Center in Atlanta, GA on April 29 – May 2, 2012.
AHI will be exhibiting at the Annual Meeting and Scientific Assembly held by the Alabama Academy of Family Physicians in Destin, Florida on June 21-23, 2012
Azalea Health Innovations, Inc.
105 West Central Avenue
Valdosta, GA 31601
Toll Free: 877-777-7686
Toll Free Fax: 866-683-8679
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