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CMS Releases List of RAC Audit Vulnerabilities

Common inpatient mistakes that often lead to claim denial In general, claims were denied because the documentation provided did not contain sufficient information to support the diagnosis, justify the treatment/procedures, document the course of care, identify treatment/diagnostic test results and promote continuity of care between health care providers. The cause of most denials was that submitted documentation did not necessitate an inpatient level of care, and care could have been provided in a less intensive setting, a Recovery Audit Contractor’s (RAC’s) report found. When admitting patients to an inpatient setting, providers need to consider several things. First, the severity of the signs and symptoms of the patient needs to be considered and documented. Also, the medical probability of adverse complications occurring should be noted. The need and availability for diagnostic studies and procedures also must be taken into account. If the patient’s medical condition, safety or health would not be threatened by providing services in a less intensive setting, then inpatient admission is not justified. The Centers for Medicare and Medicaid Services (CMS) reminds providers that all documentation must be legible. If a certain field is not applicable, “N/A” should be written. The field should not be left blank. Additionally, RAC reviewers found that certain records were not consistent. If an entry is submitted that contradicts a previous submission (due to error or otherwise) then the reason for the contradiction should be noted. Any changes in the patient’s condition or course of care should be noted, as this directly effects the reviewer’s determination. (Cont. DRG CODES Page 2)


Medical Business Journal

DRG CODES (cont from page 1) The following DRG codes were listed as the most costly denials (amount of denials multiplied by cost per denial): DRG 514/515, DRG 127, DRG 116, DRG 143, DRG 182, DRG 478, DRG 88, DRG 243, DRG 296, DRG 524, DRG 144, DRG 320, DRG 138, DRG 012, DRG 132, DRG 188 and DRG 518

Modifier Requirements Change for CPT 96110 Amongst other insurers, Blue Cross/Blue Shield (BC/BS) and United Healthcare (UHC) were denying CPT 96110 with appended modifier 59. Instead, coders that have called BC/BS and UHC have been told to use modifier 76 (Repeat procedure or service by the same physician)*. Experts say, in this case, 96110 x 2 or 96110-59 is “technically correct” seeing that modifier 59 is more appropriate than modifier 76 in describing two distinct 96110s. The reason you report two 96110s is because you are doing this to represent two different tests, not a repeat test (as modifier 76 represents). The American Academy of Pediatrics (AAP) prefers you report multiple 96110s rather than utilize any modifier at all. Reporting two 96110s indicates that the second developmental test is a separate test. Whether staff administered – or parent completed – they are two different tests. In this instance, the physician interprets and documents the tests’ interpretation. TIP: If you are directed to modifier 76, get proof! If you obtain a modifier directive (e.g. website or email confirmation) when two 96110s are reported to represent two different tests, save the documentation and adhere to the payers’ policies. Be prepared to show supporting documentation proving why you billed this way. *Modifier 76 indicates the second test was repeated. If, in fact, the modifier appropriately describes cases in which the staff must readminister the same test, and the physician reinterprets the results then, modifier 76 is appropriate.

CMS Releases Clarification Regarding CPT Code 80101

Claims with DOS on/after 1/1/2010 should use G0431 For services provided on or after January 1, 2010, new code G0431 (Drug screen, Qualitative; Single Drug Class Method) should be used in place of CPT codes 80101 and 80101QW. If a claim has been filed and denied using the old codes, then it should be resubmitted using G0431. This applies to clinical laboratories that do not require a Clinical Laboratory Improvement Act (CLIA) certificate of waiver. Additionally, claims with DOS on them should use G0431QW for laboratories that do require a CLIA certificate of waiver.

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New 2011 Observations Codes Resequenced for easier use

The 2011 CPT brings about three new E/M codes as well as significant surgical bundling of codes viewed as likely to negatively impact specialties such as cardiology and surgery practices. In 2010, the AMA debuted a tactic they call “resequencing” in efforts to group related codes together regardless of the numerical order. Three new E/M codes for “subsequent observation care” are a prime example of resequenced codes. Code range 99224-99236 has been added to represent “subsequent observation care, per day, the evaluation and management of a patient”. The location of this code range falls appropriately between, “initial observation” (99221-99223) and “inpatient hospital care” codes (99218-99220). According to the 2011 CPT, the subsequent observation codes are to be billed for observation services rendered between admission and discharge of a patient. Previously, CMS had you use outpatient office E/M for these days. This exemplifies the difference between Medicare and CPT guidelines. It is possible CMS may still continue to require outpatient office codes for these days.

CMS directs the use of Unlisted Code for Smoking Cessation Services CMS states they do not want you to bill 99406 & 99407 for smoking cessation services. They further state; these codes are still to be reserved for patients with tobacco related illnesses. Instead, CMS tells you to report unlisted CPT code 99199 for tobacco counseling services. Use ICD-9 code 305.1 & V15.82 when reporting the unlisted code. The cessation service may be provided by a physician or a qualified non-physician practitioner (NPP). The unlisted code is to be billed for services only between Aug. 25, 2010 (when CMS changed its policy for cessation services) and Dec. 31, 2010. After Jan. 1, 2011, CMS has developed the following two G-codes for you to use: • G0436, smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes and up to 10 minutes; and • G0437, smoking and tobacco cessation counseling visit for the asymptomatic patient; intensive, greater than 10 minutes. CMS states you will still use ICD-9 codes 305.1 and V15.82 to bill these codes after Jan. 1. Reminders: The physician must log the time spent; these codes are time-based. If not, the biller won’t know if the physician spent enough time to bill the service or which code to bill.

Medical Business Journal - MMIclasses.com - Issue 4, Volume 1 - November 2010

(Cont. Cessation Page 3)


Medical Business Journal

Cessation (cont. page2) • Cessation services are billable up to 8 times per year/per patient.

• If reporting with an E/M service

on the same day as the counseling, contractors will reimburse when modifier 25 is appended.

• Until Jan. 1, 2011, smoking

cessation services are subject to a co-pay and deductible.

Fourth Quarter ASP Update Drug prices increase

Two new vaccine codes appear on CMS’s Average Sales Price (ASP) list: 90662 (flu vaccine preservative free, $29.213) used for billing new FluZone shot and 90670 (pneumococcal conjugate vaccine, 13 valent, for intramuscular use, $123.833). Four drugs were deleted from this fourth quarter list as well: 90633 (hepatitis A vaccine), 90647 (hemophilius influenza B vaccine), J3364 (urokinase injection) and Q9964 (high osmolar contrast material). CMS rep says, the removal of these codes from the ASP pricing file has no impact on coverage or the validity of these codes. Further advice states to continue submitting these codes for claims processing, as they will be paid based on your local payment system. The chart (right) lists 20 of the top 50 billed drugs changed by 2% or more; 10 that decreased and 10 that increased.

Key ASP changes for Part B drugs for the fourth quarter 2010 Top Decreases Code

Short Description

Dose

J7613 J7626

Albuterol non-comp unit Budesonide non-comp unit Levalbuterol non-comp unit Fentanyl citrate injection Paclitaxel injection Cromolyn Sodium noncomp Na Ferric gluconate complex Cefepime HCl for injection Rho(D) immune globulin Morphine sulfate injection

J7614 J3010 J9265 J7631 J2916 J0692 J2792 J2270

October Payment $0.056 $4.288

Change ($) -$0.013 -$0.565

Change (%)

1 mg 0.5 mg

July Payment $0.069 $4.853

0.5 mg

$0.320

$0.211

-$0.109

-34.06%

0.1 mg 30 mg 10 mg

$0.339 $12.134 $0.447

$0.304 $7.454 $0.392

-$0.035 -$4.680 -$0.055

-10.32% -38.57% -12.30%

12.5 mg $6.609

$5.246

-$1.363

-20.62%

500 mg

$3.459

$2.668

-$0.791

-22.87%

100 iu 10 mg

$19.950 $2.093

$17.413 $1.726

-$2.537 -$0.367

-12.72% -17.53%

-18.84% -11.64%

Top Increases Code

Short Description

Dose

J7617

Mycophenolate mofetil oral Leucovorin Calcium injection Methylprednisolene Methylprednisolone Inj heparin sodium

J0640 J1030 J1040 J1644 90732 J1245 J9206 J9181 J3475

Pneumococcal vaccine Dipyridamole injection Irinotecan injection Etoposide injection Injection magnesium sulfate

Change (%)

250 mg

July October Change Payment Payment ($) $1.331 $1.506 $0.175

50 mg

$0.945

$1.048

$0.103

10.90%

40 mg 80 mg 1,000 units 0.5 ml 10 mg 20 mg 10 mg 500 mg

$3.350 $6.383 $0.357

$4.718 $8.594 $0.433

$1.368 $2.211 $0.076

40.84% 34.64% 21.29%

$43.248 $0.901 $4.310 $0.404 $0.043

$49.734 $1.100 $6.123 $0.548 $0.049

$6.486 $0.199 $1.813 $0.144 $0.006

15.00% 22.09% 42.06% 35.64% 13.95%

13.15%

Source: CMS’s ASP lists for the third and fourth quarters of 2010. Drugs on this chart are those with price swings of 10% or more, ranked in order of number of claims billed in 2008. Fourth quarter prices effective 10/1/10 to 12/31/10.

Medical Business Journal - MMIclasses.com - Issue 4, Volume 1 - November 2010

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iPadTM Corner

Medical Business Journal

Certified EHR Products for the iPad How an iPad can help achieve meaningful use

While you are searching for ways to meet meaningful use requirements for using Electronic Health Records (EHR), you still need hardware to operate the EHR products on. While there are EHR products available on a variety of platforms, the ability to remotely connect to the main database is in high demand. When doctors are able to manage patient information on the go, they are much more enthusiastic about the adoption of EHRs. The iPad is one such device that developers are targeting, creating certified apps that satisfy both complete meaningful use and modular apps that work together, all to help providers earn those key incentive funds. Below are brief reviews of such products, which are all compatible with the iPad.

Physician’s Solution

This application is a patient information management system, which offers 24/7 remote access to patient records. It can effectively replace paper charts and can communicate directly with billing departments. It even has a handwriting recognition function, so it can function the same as if you were writing on paper, and a scanning mechanism to convert old paper charts into a digital medium. Physician’s Solution is Office of the National Coordinator - Authorized Testing and Certification Body (ONC-ATCB) certified for stage 1 meaningful use. It was certified by Certification Commission for Health Information Technology (CCHIT) and has met all certification criteria adopted by the Secretary of Health and Human Services for the EHR incentive program. Information on Physician’s Solution is available at: http://uniehr.com/solutions-services/physicians-solution

Compulink Advantage/EHR 10

This customizable EHR solution offers built-in coding assistance and electronic prescribing formularies to help maximize bonus incentive payments. It has 150 diagnostic equipment interfaces and can link to a patient web portal, allowing patients to easily view their records remotely. You can enter data straight into your iPad and transfer it wirelessly. This product will allow practices to input and manage EHRs in a variety of different ways, including graphs and remote patient interaction. Both doctors and patients have their own apps specifically geared to their individual needs. Compulink Advantage/EHR 10 is ONC-ATCB certified complete EHR for stage 1 meaningful use. It was certified by CCHIT and Compulink also offers a guarantee that “you’ll be successful with EHR or we’ll refund your full investment.” Information on Compulink’s Advantage/EHR 10 is available at: http://www.compulinkadvantage.com/advantage/electronic-healthrecords.html

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Doctations, Version 2.0

This product is an internet-enabled, digital medical record documentation, practice management, and billing administration system. It is fully compatible with the iPad and can also be remotely accessed by it over a secure, encrypted internet connection. Doctations V. 2.0 is ONC-ATCB certified complete EHR for stage 1 meaningful use. It was certified by CCHIT: certification number: CC1112-371480-1. Doctations relies on medicalHome, a complete patient health information system, which is free with registration to DocPatientNetwork. Information on Doctations V. 2.0 is available at: http://www.doctations.com/products/doctations.asp

MacPractice MD 4.0

This tool centers on a database, which stores and organizes patient data. From this database physicians can search, share and analyze EHRs while managing their medical practice. The tool also has imaging features, so doctors can actually download X-rays to their iPad on the go and show them to patients, further enhancing the doctor/patient experience. MacPractice MD has met preliminary certification measures as a complete EHR product by the CCHIT and is predicted to meet 24 of 24 requirements for stage 1 meaningful use. Information on MacPractice MD is available at: http://www.macpractice.com/mp/md/

CMS Releases 2010 MCPSS Results Part B MACs had lowest overall satisfaction rating of any contractor type

The 2010 Medicare Contractor Provider Satisfaction Survey (MCPSS) was based on a 5 point rating system, with 1 being extremely dissatisfied and 5 being extremely satisfied. A total of 18,458 providers responded to the survey. The overall satisfaction rate for all contractor types was heavily skewed toward satisfied or very satisfied responses (S/VS), with 49.71 and 19.16 percent of responses respectively. Conversely, overall dissatisfaction and extreme dissatisfaction were 8.22 and 5.16 percent respectively. Overall satisfaction for Part B MACs was markedly below FIs, Part A MACs and RHHIs, with the former rated at 67 percent S/VS and the latter rated between 77 and 81 percent S/VS. Part B MACs also had the highest level of overall dissatisfaction at nearly 17 percent. Of respondents, hospices, ESRD providers, and rural health providers expressed the highest rate of satisfaction. Licensed practitioners and laboratories provided the highest dissatisfaction rates at 15 and 17 percent respectively. A full copy of the report, with tables and detailed readouts of all scores, is available at http://www.cms.gov/MCPSS/

Medical Business Journal - MMIclasses.com - Issue 4, Volume 1 - November 2010


Medical Business Journal

52 Certified EHRs Vendor

Product

ABEL Medical Software Inc. Allscripts Allscripts Allcripts

ABELMed EHR-EMR/PM Allscripts PeakPractice Allscripts Professional EHR Allscripts ED

Aprima Medical Software Inc. athenahealth, Inc. Cerner Corporation

Aprima

ChartLogic, Inc.

Product Version #

Product Classification

Certifying ATCB

11 5.5 9.2 6.3 Service Release 4 2011

Complete EHR Modular Complete EHR Modular

CCHIT CCHIT CCHIT CCHIT

Modular

CCHIT

Complete EHR Modular

CCHIT CCHIT

ChartLogic EMR

10.1 Version 2001.19.12, P2 Sentinel Version 4.2.1 7

Complete EHR

Compulingk CureMD Corporation DocPatientNetwork eClinicalWorks LLC Emdeon Inc.

Advantage/EHR CureMD EHR Doctations eClinicalWorks Emdeon Clinician

10 Version 10 2 8.0.48 7.4

Complete EHR Complete EHR Complete EHR Complete EHR Complete EHR

empowersystems

empowersystems (ambulatory)

1.1.57

Complete EHR

empowersystems

empowersystems (inpatient)

1.1.57

Complete EHR

Epic Systems Corporation Epic Systems Corporation GE Healthcare GE Healthcare gloStream, Inc. Greenway Medical Technologies, Inc. Health Care Systems, Inc. ifa united i-tech Inc.

EpicCare Inpatient - Core EMR EpicCare Ambulatory -Core EMR Centricity Advance Centricity Practice Solution gloEMR PrimeSuite

Spring 2008 Spring 2008 10.1 9.5 6 2011

Complete EHR Complete EHR Complete EHR Complete EHR Complete EHR Complete EHR

Drummond Group Inc. CCHIT CCHIT CCHIT CCHIT Drummond Group Inc. Drummond Group Inc. Drummond Group Inc. CCHIT CCHIT CCHIT CCHIT CCHIT CCHIT

HCS EMR ifa EMR

4 6

Modular Modular

Intiva, Inc

InSync

5.4

Complete EHR

Intuitive Medical Software IO Practiceware, Inc Kabot Systems

UroChartEHR IO Practiceware VistaA++ EHR Office Edition

4 7 2.0.0.1

Complete EHR Complete EHR Complete EHR

MCS - Medical Communication Systems, Inc.

iPatientCare

10.8

Complete EHR

atheaClinicals Cerner Millennium Powerchart, Cerner Millennium FirstNet, Health Sentry, Cerner Health Exchange and

Medical Business Journal - MMIclasses.com - Issue 4, Volume 1 - November 2010

CCHIT Drummond Group Inc. Drummond Group Inc. CCHIT CCHIT Drummond Group Inc. CCHIT

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Medical Business Journal

52 Certified EHRs Vendor

Product

Medical InformanticsEngineering Meditab Software, Inc. NeoDeck Software Netsmart Technologies

WebChart EHR

Version 5.1

Product Classification Complete EHR

IMS NeoMed EHR Avatar

v. 14.0 3 2011

Complete EHR Complete EHR Modular

Networking Technology dba RxNT NexTech Systems Inc. nextEMR, LLC nextEMR, LLC NextGen Healthcare Nortec Software Inc. PeriGen Prognosis Health Information Systems Pulse Systems QRS, Inc.

RxNT EHR

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Modular

CCHIT CCHIT Drummond Group Inc. CCHIT

NexTech Practice 2011 nextEMR, LLC nextEMR, LLC NextGen Ambulatory EHR Nortec EHR PeriBirth ChartAccess

9.7 1.5 1.5 5.6 SP1 7 4.3.51 4

Complete EHR Modular Complete EHR Complete EHR Complete EHR Modular Complete EHR

CCHIT CCHIT CCHIT CCHIT CCHIT CCHIT CCHIT

2011 Pulse Complete EHR PARADIGM

2011 8.3

Complete EHR Modular

Sammy Systems StreamlineMD, LLC SuccessEHS SuiteMed The DocPatientNetwork.com T-System Technologies, Ltd. Universal EMR Solutions Vision Infonet Inc. WellCentive Wellsoft Corporation

SammyEHR StreamlineMD SuccessEHS Intelligent Medical Software (IMS) Doctations T SystemEV Physician’s Solution MDCare EMR WellCentive Patient Registry Wellsoft EDIS

5.1.1 10.8 6 V14 2 2.7 5 4.2 Version 2.0 v11

Modular Complete EHR Complete EHR Complete EHR Complete EHR Modular Complete EHR Modular Modular Modular

CCHIT Drummond Group Inc. CCHIT CCHIT CCHIT CCHIT CCHIT CCHIT CCHIT CCHIT CCHIT CCHIT

Another HHS Federal Funding Opportunity

$335 million to increase access to primary health care Under the Expanded Services (ES) initiative, the availability of $335 million for existing community health centers was announced Oct 26. The funds intend to help the health centers accommodate more patients, regardless of the patient’s insurance status. This action is in line with the Department of Health and Human Services’ (HHS’s) focus on preventative and primary health care.

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Product Version #

Certifying ATCB CCHIT

Applicants for this funding must demonstrate how these funds will be used to increase healthcare access to underserved populations. The following categories of health centers are eligible: • Community Health Centers (CHC) Section 330(e) • Migrant Health Centers (MHC)-Section 330(g) • Health Care for the Homeless (HCH)-Section 330(h) • Public Housing Primary Care (PHPC)-Section 330(i) Applications are due by 8 pm ET, January 6, 2011. Information on how to apply for this funding is available at: http://bphc.hrsa.gov/es/

Medical Business Journal - MMIclasses.com - Issue 4, Volume 1 - November 2010


CMS Releases Proposed LTC Regulation

Medical Business Journal

Hospice Care Process Clarified

The Centers for Medicare and Medicaid Services (CMS) released a proposed rule concerning hospice care provided in long-term care (LTC) facilities, such as skilled nursing facilities (SNF) and nursing facilities (NF). Now a written agreement between the hospice provider and LTC provider will be required in order to clearly identify the duties of each entity in providing care to Medicare or Medicaid beneficiaries. The rule would require the signatures of authorized personnel representing both entities. The hospice would be responsible for making decisions concerning the terminal illness, while the LTC facility would make decisions concerning other medical needs, and keep the hospice provider informed of all changes in the care plan. The written agreement would need to specifically delineate methods of communication between the LTC provider and hospice provider, as well as conditions requiring immediate coordination between the two entities. It would also require the LTC provider to provide 24/7 room and board, and require the hospice provider to be responsible for determining the appropriate course of hospice care. This agreement would be required even if the same company or organization owned the LTC and hospice providers. CMS is asking for comments about “how LTC facilities can provide orientation for hospice staff that is quick and efficient but sufficient to protect residents who receive hospice care.” Information about how to comment can be found in the full text, at: http://edocket.access.gpo.gov/2010/2010-26395.htm

CMS Holds Provider Education Call on HIPAA Version 5010 Transition begins 2011

regulation updates, as this will cover the transition. Also make sure that your vendor can assure the transition before the 2012 deadline, preferably in writing. Make sure you hash out all legal agreements with any trading partners (vendors, etc.) before the transition begins. In addition to the required software changes, workflow models might also have to change. Additional data will need to be entered, so make sure to accommodate this. Remember that for the whole 2011 year, both 5010 and 4010 codes will be accepted. This will allow for any tech problems and troubleshooting during the transition, so if the new system goes down work can continue on the old one. However, starting 2012, only the new codes will be accepted in preparation of the ICD-10 switch, so have all the bugs worked out by then. You can purchase implementation guides at: http://store.x12.org/

Medical Business Journal Volume 1, Issue 2

Managing Editor Assistant Editor Contributors Layout and Design Production

Jennifer Donovan, RMC, CPC, RMM Christopher Myers Christopher Myers Jennifer Donovan, RMC, CPC, RMM Mike Calkins, ADN, RMC Chris Rottmann Clockwork Graphics

Medical Business Journal is a monthly publication available through subscription for $99.95 per year or $159.95 for two years (additional copies and reprints are available for $20/issue). The Medical Management Institute is not affiliated in any way with the Department of Health and Human Services, Medicare, or the Centers for Medicare and Medicaid Services. This publication is designed to provide accurate and authoritative information with regard to the subject matter covered. It is sold with the understanding that the publisher is not engaged in rendering legal, accounting or other professional services, and is not a substitute for individualized expert assistance. The CPT codes, descriptors, and modifiers are copyrighted by the American Medical Association. For more information, please call MMI at 1-866-892-2765.

HIPAA ASC X12 Version 5010 and NCPDP D.0 is a new pair of shoes to replace the worn out soles of Version 4010. These new Health Insurance Portability and Accountability Act (HIPAA) Accredited Standards Committee (ASC) and National Council for Prescription Drug Programs (NCPDP) standards will require full compliance by January 1, 2012. In order to ease the transition, CMS has been providing a series of teleconferences and materials to providers across the nation. Here is the breakdown of what was covered in one such call. There are a few steps that you can take immediately to begin the transition process. First, you need to open up a dialogue with your vendor. If you haven’t done this yet, do it immediately, before the transition starts January 1, 2011. Find out if your license includes Medical Business Journal - MMIclasses.com - Issue 4, Volume 1 - November 2010

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Medical Business Journal

The Registered Medical Manager Online Certification Sample Topics Goals & Strategic Planning Setting Goals Personal Goals Professional Goals Practice Goals Goal Statements Planning for Success Marketing and Medicine Marketing and Healthcare Patient Relations Practice Newsletters Survey for Managed Care Patients Benefits & Wages Minimum Wage Laws Healthcare Benefits COBRA ERISA Compliance Overview What is Compliance? Structure of the Compliance Plan Internal Auditing & Monitoring Process Developing a Disciplinary Standard & Guidelines

Financial Outcomes and Controls Budgeting Cash Flow Management Receipt Controls Internal Auditing and Billing Controls Management Review Guidelines Compliance Coding & Billing Coding & Billing Modifiers Retention of Records Educational Training in the Medical Practice

The coursework is all self-paced. You can move through the material as your schedule allows, call into your instructor when you have questions or discuss topics with other students online. http://www.webex.com/

Organizations/Income Distribution Practice Organization Physicians as Managers Executive Committees Income Division Formula

Just Added Health Care Reform Impletementation Explanation Effective Dates

Leadership & Management Leadership: Be a Big Thinker A Philosophy of Leadership Personnel & Policies Management Reporting LEARN MORE ABOUT THE REGISTERED MEDICAL MANAGER PROGRAM Call: 866.892.2765 or visit us online: www.mmiclasses.com/RMM.html

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Each student is assigned a course advisor and an instructor. The instructor will be your main point of contact throughout the duration of the program. Any time you have an issue or career question, you can contact your course advisor.

Using the Webex application, Instructors can conduct live presentations when needed. Also, you will find course materials and reference manuals are included in your tuition fee. You can also use it to access the school’s online classroom!

Medical Business Journal - MMIclasses.com - Issue 4, Volume 1 - November 2010


Medical Business Journal

“I have to know this infomation for my job. I figured I might as well save $340 on tuition fees and get my iPad.” Shelbie Rjelk MMI Student , 2010/2011

You get this... to keep!

Apple iPadTM 16gb Wi-Fi & • RAC Readiness Training for 2011 • Meaningful Use & EHR • E&M: Consults, Observations & the Details • 2011 Coding for Optimail Reimbursement •What you need to know about ICD-10 in 2011

Five coding classes, 12 CEUs and an iPad; sounds like a great present! Here is a way to learn everything you need to know about coding and billing in 2011, earn CEUs and get it all at an astonishing low price! The iPad is now included as “standard course material” for almost all of the Medical Management Institute’s programs, mini-classes, certification courses and CEU suites. Upon enrollment into your courses, your iPad can be included in the tuition fee! The iPad is a useful tool for the entire practice; coders and managers will benefit from the amazing applications specifically designed for health care professionals and the physician can use the device to better educate patients on their medical conditions. Not ready for an iPad? No problem, all of the school’s winter-quarter classes are available on your Mac or PC. If your tight on time, each one is also available as a self study program to access when your schedule permits. Of course, all of the school’s classes are fully supported by tenured Institute instructors who understand that your questions are just as important as the presentation of the material. Each student is actively encouraged to contact their instructor when there are problems understanding any part of the material. If you are even remotely considering this, REGISTER AS SOON AS POSSIBLE! The school must order and custom configure each iPad before it leaves the school. The Medical Management Institute Business success in health care for over 25 years.

Robert D. Keene Sr Board Chairman 2010

The Medical Management Institute is a government licensed school authorized under the Nonpublic Postsecondary Educational Institutions Act of 1990. License No. 833 Dept of Education’s IPEDS: 458520

Medical Business Journal - MMIclasses.com - Issue 4, Volume 1 - November 2010

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Medical Business Journal Tuition $110 for single course $739 for full course load and iPad

Introduction What does “meaningful use” mean to a coder? This session covers criteria and measurement metrics that CMS will use to determine physician eligibility for financial incentives in 2011 and moving forward. As CMS states: To realize improved health care quality, efficiency and patient safety, the criteria for meaningful use will be staged in three steps over the course of the next five years. Stage 1 sets the baseline for electronic data capture and information sharing. Stage 2 (est. 2013) and Stage 3 (est. 2015) will continue to expand on this baseline and be developed through future rule making. Lesson Preparation Opportunities for coders will be identified to assist practices in preparing for “meaningful use” of their EMR Systems.

Course Materials iPad™ 16gb Wi-Fi (Full Course Load Only) Duration This course is 1 hour long Availability Live 01/12/2011 2:00 till 3:00 EST Downloadable Copy* Format Web based, Instructor Led -orWeb based, Instructor Supported Self Study *Archived Copies of the class will be available to students who cannot attend or missed the live scheduled class.

Final Exam & Grading The course will be followed by a quiz which the student can access online at their convenience. **The Institute will be testing new iPad units during this course. Students who are part of this program should contact the school upon receipt of their device. Tuition $110 for single course $739 for full course load and iPad

Introduction RAC stands for Recovery Audit Contractor. In most instances you have no need to worry. You simply need to get the information behind this process, implement practical guidelines and move on with your day. The Recovery Audit Contractor program was initiated to improve efficiencies within the Medicare system and reduce unnecessary reimbursement. The program has also provided the added benefit of improving the bottom line of many health care organizations nation wide. By conducting an internal mock RAC audit, many students will recognize efficiencies in their organization they never knew were present before. Lesson Preparation This course will teach the student how to develop a RAC check list and how to response to an audit request. All materials are based online. iPad students will view the program through GoToMeeting’s iPad application.

Course Materials iPad™ 16gb Wi-Fi (Full Course Load Only) Duration This course is 1 hour long Availability Live 02/16/2011 2:00 till 3:00 EST Downloadable Copy* Format Web based, Instructor Led -orWeb based, Instructor Supported Self Study *Archived Copies of the class will be available to students who cannot attend or missed the live scheduled class.

Final Exam & Grading The course will be followed by a quiz which the student can access online at their convenience. **The Institute will be testing new iPad™ units during this course. Students who are part of this program should contact the school upon receipt of their device.

To Enroll Call: 866.892.2765 or goto: MMIclasses.com/winter 10

Medical Business Journal - MMIclasses.com - Issue 4, Volume 1 - November 2010


Medical Business Journal Coding for Optimal Reimbursement: Updates & Changes

Introduction This session will cover the major revisions within the 2011 coding sources. We will also take a look some cost saving measures with alternatives to paper based coding materials and replacements for priced subscription software applications.

Tuition $110 for single course $739 for full course load and iPad Course Materials iPad™ 16gb Wi-Fi (Full Course Load Only)** Duration This course is 1 hour and 30 minutes long

Areas include: E/M General Surgical Pain Medical Pulmonary Medicine Radiology Gastroenterology and more!

Availability Live 2/02/2011 2:00 till 3:30 EST Downloadable Copy*

Lesson Preparation Each student should have either the ebook copy or paper based copy of the appropriate coding manual for that session. At the conclusion of the first ICD session the instructor will announce the next date for the CPT session and HCPCS sessions. Final Exam & Grading The course will be followed by a quiz which the student can access online at their convenience.

Evaluation & Management: Consults, Observations & Details

Introduction Keep pace with proper and compliant reimbursement for 2011. This session includes new guidelines, modifiers and important E/M changes. Lesson Preparation This session will be dedicated to communicating the new guidelines set for 2011 regarding evaluation and management. Final Exam & Grading The course will be followed by a quiz which the student can access online at their convenience.

Format Web based, Instructor Led -orWeb based, Instructor Supported Self Study

Tuition $110 for single course $739 for full course load and iPad Course Materials iPad™ 16gb Wi-Fi (Full Course Load Only)** Duration This course is 1 hour and 30 minutes long Availability Live 03/16/2011 2:00 till 3:00 EST Downloadable Copy* Format Web based, Instructor Led -orWeb based, Instructor Supported Self Study

What you need to know about ICD-10 in 2011

Introduction Believe it or not, the ICD got its start in the 1850s. The first edition was known as the International List of Causes of Death. It was used by the medical community as far back as 1893. The World Health Organization (WHO) took over the responsibility in 1948 when ICD-6 was released. This edition was set apart from its predecessors by including causes of morbidity for the first time. In 1967 WHO adopted the nomenclature regulations which stipulates that everyone must use the most current version of ICD for mortality and morbidity statistics by all members of WHO. There is only one big problem, the United States of America does not use it. Yes, the USA is a member of WHO. ICD-10 was announced by WHO during the May 1990 assembly. It came into use by most WHO member countries in 1994. It was first proposed to the US Health Care System as far back as 1992 but each and every time it was slated for enactment those in charge delayed implementation. This time many feel it is for real; others think the timing could not be worse considering the economic stresses the entire country is under. One thing we know for sure is the country has another election cycle ahead of it. Some feel this could be a platform for delaying the implementation- at this point no one is sure. ICD 10 will cause economic ripples through health care unseen since the advent of managed care. As for today, it is important to know what might be ahead, how it will effect your practice and what you can expect in your job. This course will address all of these topics and many more. Lesson Preparation The course will examine the possibilities of ICD 10, explain what is necessary at this juncture and how to prepare should this come to pass.

Tuition $110 for single course $739 for full course load and iPad Course Materials iPad™ 16gb Wi-Fi (Full Course Load Only)** Duration This course is 1 hour and 30 minutes long Availability Live 03/02/2011 2:00 till 3:30 EST Downloadable Copy* Format Web based, Instructor Led -orWeb based, Instructor Supported Self Study *Archived Copies of the class will be available to students who cannot attend or missed the live scheduled class. **The Institute will be testing new iPad™ units during this course. Students who are part of this program should contact the school upon receipt of their device.

Final Exam & Grading The course will be followed by a quiz which the student can access online at their convenience.

Medical Business Journal - MMIclasses.com - Issue 4, Volume 1 - November 2010

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Medical Business Journal

Phone:866.892.2765 Enrollment Fax: 678.669.2483 Enrollment Online: mmiclasses.com/winter

The Medical Management Institute Enrollment Form 2011 Winter Quarter

2011 Winter Courses Coding & Billing for Medical Reimbursement

CourseID

Title

CEs

Date

Time

MEAN1011

Meaningful Use & EHR

2

01/12/2011

2:00-3:00

CODE1011

2011 Coding for Optimal Reimbursement: Updates & Changes

3

11/24/2010 & 02/02/2011

2:00-3:30

RAC1011

RAC Readiness Training Winter 2011

2

02/16/2011

2:00-3:00

ICD1011

What you need to know about ICD-10 in 2011

3

2:00-3:30

EM1011

Evaluation & Management: Consults, Observations & Details

11/30/2010 & 03/02/2011

2

03/16/2011

2:00-3:00

The Medical Management Institute is a government licensed school authorized under the Nonpublic Postsecondary Educational Institutions Act of 1990. License No. 866 Dept of Education’s IPEDS: 458520

Tuition Fees: All 5 Courses

All 5 Courses w. iPad

TM

Method

Online live or Self Study Online live or Self Study Online live or Self Study Online live or Self Study Online live or Self Study

$ 550 $339.99 $1078 $739.99

Directions for Enrolling: Students can choose between presentations on the new iPad platform or a Mac or PC. If you cannot attend the live dates, all sessions are now online to access when you have the time. For those using the iPad, the device will ship upon receipt of tuition. Please contact the school when your iPad is delivered; an instructor will conduct an orientation of the device and demonstrate how to use it duing the classes. Individual courses are $110 per session. For single course registrations, please contact the school 866-892-2765. Mark your payment terms below and fax this form to 678.669.2483, or you can mail it to: 11660 Alpharetta Hwy. Ste 545, Roswell, GA 30076. To enroll online go to www.mmiclasses.com/winter

The Medical Management InstituteTM

11660 Alpharetta Hwy Ste 545 Roswell, GA 30076 866.892.2765 • mmiclasses.com • info@mmiclasses.com

Student: Email: Phone: Tuition Fees Medical Reimbursement Training Series (Winter 2011)

To Begin Enrollment Please Print, complete this form & fax To 678.669.2483 or online at mmiclasses.com/winter iPad is a registered trademark of Apple, Inc. All rights reserved. Apple is not a participant in or a sponsor of these courses.

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All 5 Courses & iPad....$739.99 All 5 Courses, no iPad...$339.99 iPad & 2011 eICD-9 & eHCPCS...$600.99 Payment Info AMEX MasterCard Visa Discover Check Enclosed Student Loan Pell Grant Funds

Card No. Exp. Signature

Medical Business Journal - MMIclasses.com - Issue 4, Volume 1 - November 2010

For single course registrations, please contact the school 866-892-2765.


Medical Business Journal