MedBeyond Newsletter
July 2008

Medicare News Update

Please view the following website link for instructions in checking Medicare eligibility on patients. This is very important considering that there are so many different Medicare HMO’s and Fee for Service Plans patients can subscribe to instead of traditional Medicare Part B.

Visit Website

PQRI (Physician Quality Reporting Initiative)

This program was implemented by Medicare back in the summer of 2006 with the opportunity for physicians to earn a 1.5% bonus base on reporting on at least three PQRI indicators successfully 80% of the time. The bonus is supposed to be calculated base on your Medicare allowables. There has not been any PQRI bonus checks issued as of yet. For those physicians who participate with PQRI, please view the website link below for the most up to date information. Visit Website

CODING CHANGES FOR 2009 !!!

Get ready for a total of 519 CPT code changes starting in January. The AMA has revealed that you can expect nearly 300 new codes, including 17 new evaluation and management codes, 36 new surgery codes and 67 new codes in the Medicine section. Please see the table on the right…

You will have 133 revised codes to prepare for. The table below, from the AMA, breaks out the changes to expect in CPT 2009 by section:

Using Modifier-58 Correctly

Staged or related procedure or service by the same physician during the postoperative / global period.

The modifier-58 is used when the second and/or related staged services are performed during the postoperative period of the original (first) procedure. This modifier used on the second procedure performed during the 90-day global period is reimbursed at a 100% just like the first procedure. A new postoperative period begins when the next procedure in the staged procedure series is billed.

Use modifier-58 in certain cases. For example a heavily contaminated wound that requires repeated debridement. The subsequent debridement procedures would be appended with the modifier-58. Another example is when an incisional prostate biopsy is done, and the specimen returns from the pathologist as “positive” CA of the prostate.” Within the 10 day follow up period of the prostate biopsy, a radical perineal prostatectomy with bilateral pelvic lymphadenectomy is performed. The correct coding for this case would be: 55815-58

SERVICES

• MediSoft Billing & Scheduling Software               
• Billing & Collections 
• Application & Email Hosting
• Electronic Claims Processing Management
• Training & Support
• Comprehensive IT Solutions
• Vision Software: Medical Records and Inventory
• Server & Networking Hosting
• Data Conversion
• Statement Mailing with payment envelope
• Claims Clearinghouse, Eligibility, Auto Posting with Collection/Payment tracking

MEDISOFT: MedBeyond will be upgrading to version 14 by Mid July 2008
***Stay tuned for notification***

e-PRESCRIBING

Improve Efficiency
      *Minimizing time spent phoning and faxing to clarify prescriptions and authorize renewal requests

Improve Safety and Quality of Care
      *Greatly reducing errors due to misread prescriptions and medications with similar sounding names

Increase Patient Satisfaction
      *Decreasing pharmacy wait times while improving safety

Provide true Connectivity to more than 75% of pharmacies
      *Including Brooks, CVS, Stop & Shop, Walgreens, Wal-Mart, and many Independent Pharmacies

Increase Staff Productivity
      *Simplifying staff workflow allowing completion of refill authorizations in seconds, not hours