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SlitLamp provides illuminating e-news for Colorado ophthalmologists. It keeps you in the know on the evolving Colorado health care scene by detailing the latest legislative and regulatory happenings. It also spotlights the information and resources you need for your practice.

 

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AAO action request: Document postoperative visits

Posted By Chet Seward, Tuesday, August 14, 2018
The American Academy of Ophthalmology (AAO) encourages all ophthalmologists to document postoperative visits each time with CPT code 99024. This is a crucial step to the valuation of ophthalmic surgical codes.

Background
A year ago, AAO worked together to alert ophthalmologists about required postoperative data under the Medicare Access and CHIP Reauthorization Act of 2015. In the 2019 proposed Physician Fee Schedule rule, the Centers for Medicare and Medicaid Services (CMS) provided AAO with some interim results of that effort but reminded AAO that the data collection continues. The good news is that CMS has not proposed to implement any payment changes for January 1, 2019 based on the data collected so far giving us a chance to improve responses.
As you recall, the 2015 law barred the CMS from eliminating 10- and 90-day global surgical payments, which the agency deemed misvalued due to studies that showed that some surgeons were not providing the "built in" postoperative visits. Instead, the law authorized CMS to collect data on such services to review the valuation of surgical services from a representative sample of physicians. That is why it is essential that you document these postoperative visits as data collection continues. 

Initial data collection outcomes
Ophthalmology's overall participation rate was significantly higher than the very low 45% average during the first six months of data collection, but some providers are not documenting even a single postoperative visit. Having the best possible estimate of the number of postoperative visits is crucial to support the valuation of our surgical codes. Please document these postoperative visits each time with CPT code 99024.

Tags:  practice management 

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Don't forget to revalidate with Medicare

Posted By Chet Seward, Tuesday, December 6, 2016

Medicare requires that enrolled providers and suppliers revalidate per the Affordable Care Act. Revalidation are due on the last day of the month according to your revalidation schedule. The local Medicare Administrative Contractor Novitas should send you a revalidation notice about two-three months prior to your due date. If you're curious about what your date is then search here.

Find out all you need to know about provider revalidation here. Avoid holds on your Medicare payment or deactivation of your Medicare billing privileges by keeping your provider revalidation up to date. Contact Novitas if you have any questions.

Tags:  practice management 

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Physicians must post notices of non-discrimination by Oct. 17, 2016

Posted By Chet Seward, Tuesday, December 6, 2016

Under new HHS rules implementing the ACA nondiscrimination provision, covered entities (which includes most health care providers) must post and publish new mandatory nondiscrimination statements and taglines by October 17, 2016. The final rule coordinates existing federal nondiscrimination laws, regulations, and policy regarding race, color, national origin, age, and disability as they apply to health care coverage and care. The rule codifies HHS’s long-standing policy guidance on language assistance for individuals with Limited English Proficiency (LEP), and incorporates provisions of the Americans with Disability Act (ADA) to prohibit disability-based discrimination in health programs and activities.

The rule applies to those who provide or administer health-related services or insurance coverage and receive “federal financial assistance.” Federal financial assistance includes Medicare, Children’s Health Insurance Program, Medicaid, meaningful use incentive payments, HHS grants, Centers for Medicare and Medicaid Services gain-sharing demonstration projects, federal premium and cost-sharing subsidies, etc.

The rule does not apply to physicians who only receive payments from Medicare Part B (traditional Medicare), unless they are also receiving meaningful use incentive payments.

Covered physicians must:

  • By October 17th post a notice of nondiscrimination and taglines in the top 15 languages in the state.
  • Designate a compliance coordinator and adopt grievance procedures (applicable to group practices with 15 or more employees).
  • Covered entities are encouraged to develop and implement a language access plan.

For more information and sample documents click here.

Tags:  practice management 

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