PARA Weekly Update Grayscale Version 8-8-18

Date

PARA WEEKLY

UPDATE For Users

I mproving T he Business of H ealthCare Since 1985 August 8, 2018

NEWS FOR HEALTHCARE DECISION MAKERS

IN THIS ISSUE QUESTIONS & ANSWERS - Billing For Eyeglasses Post Cataract Surgery - Patient Not Present At Visit - Cancer Related Fatigue - Testicular Implant Prosthesis NEW! PARA'S SHARE OF COST ESTIMATOR: HOW IT WORKS

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NEW! TECHNICAL CHANGE TO INPATIENT ORDERS RULE FOR 2019 IPPS NEW! RURAL HEALTHCARE GRANTS MLNCONNECTS MEDICARE PROPOSES TO CEASE THERAPY G-CODES IN 2019 PARA OUTMIGRATION REPORTS

PARA COMPANY NEWS

SERVICES

ABOUT PARA

CONTACT US

FAST LINKS

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The number of new or revised Med Learn (MLN Matters) articles released this week. All new and previous Med Learn articles can be viewed under the type "Med Learn", in the Advisor tab of the PARA Dat a Edit or . Click here -------------------------------------------------------

The number of new or revised Transmittals released this week. All new and previous Transmittals can be viewed under the type "Transmittals" in the Advisor tab of the PARA Dat a Edit or . Click here.

Administration: Pages 1-37 HIM /Coding Staff: Pages 1-37 Ophthalmology: Page 2 Providers: Pages 2,3,5,13,16-18,33 - Pharmacy: Pages 22,33 - Practice M anagement:Page 3

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PDE Users: Page 7 Public Affairs: Page 7 Finance: Pages 7,27,29-32,34 Rural HealthCare: Page 15 Hospitalists: Page 13 Business Development: Page 19 Training: Page 18 Behavioral Health: Page 21

© PARA Healt h Car e An alyt ics CPT® is a r egist er ed t r adem ar k of t h e Am er ican M edical Associat ion

PARA Weekly Update: August 8, 2018

BILLING FOR EYEGLASSES POST CATARACT SURGERY

We do not have a DME license. Can you validate the information below in response we asked an optical provider?

"Yes, the patient is entitled to a pair of standard frames and glasses post cataract, but we are not a DME participating provider so we cannot bill for the glasses as it will be denied.

The glasses charge is currently with the optical shop not in the GE system. The bill the patient is referring to below is not for glasses but a follow-up visit 99213 and eye refractions 92015 on 1/2/2018.

We understand that we are saying the 99213 should have been post-op as the 66984 done on 11/27/2017 carries a 90 day global. The 99213 went to the patients deductible, and the 92015 is never covered because the patient is always responsible. We suggest that the 99213 be charge corrected to a 99024 and if the refractions are necessary for the prescription that the 92015 be removed as billed in error.

Can you tell me if the refraction is necessary for a proper prescription? Any correction on this needs to be done with Medicare online.

1. He was seen in optometry after surgery for a new glasses prescription and was billed for the visit.

He has the understanding that he should have never been billed for the visit as it was a ?follow up after cataract surgery visit?. The bill was about $300, Medicare paid some and he still has a remaining balance of $138. I told him that we would ?write off? his balance. Going forward I do think that we need to have the Optical shop be clear maybe a document that the patient signs that acknowledges that we are not a DME provider and they still want their glasses from us? Also we need to look into the eye department and how they handle their post-ops, are they charging visit where it should be a post op for a check and prescription?

Answer: The response you received as written above is correct, Medicare will cover a single pair of standard frame eyeglasses post-cataract surgery, but only if ordered by an enrolled provider and supplied by an enrolled DME supplier.

Here?s a link and an excerpt from Medicare?s patient information website: https://www.medicare.gov/coverage/eyeglasses-contact-lenses.html

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PARA Weekly Update: August 8, 2018

PATIENT NOT PRESENT AT VISIT

What is the correct coding on the following physician documentation?

Physician Note [Physician name], MD Internal Medicine Diabetes mellitus type 2 in nonobese (HCC) Dx Progress Notes Date of visit: Monday April 2, 2018 SUBJECTIVE: [Patient]'s long-time partner is here. [Patient] is not present today. She is concerned about his medication list. He is over at [facility] in the memory unit and all his medications have been managed through that unit. She had questions about the medicines however wanted to review them. She also wanted to discuss the differences between his insulin and dosing. We already rectified these issues already however we did review them today.

PROBLEM LIST: Patient Active Problem List Diagnosis ? [redacted] EXAM: There were no vitals taken for this visit. There is no height or weight on file to calculate BMI. none ASSESSMENT/PLAN: No orders of the defined types were placed in this encounter. Diagnosis & Plan ICD-9-CM ICD-10-CM 1. Diabetes mellitus type 2 in nonobese (HCC) 250.00 E11.9 Hemoglobin A1c We reviewed his medications and the rationale for each medicine She is reassured that he requires more consistent care and indeed she had been caring for him longer than most people would have been capable of No Follow-up on file.

Answer: Your question title included the codes 99358 (prolonged E/M, first hour) and 99359 (prolonged E/M, each add?l 30 minutes):

The prolonged E/M codes 99358 and 99359 are not reportable because the supplied documentation does not indicate the amount of time the physician spent in this encounter.

The encounter above fits the description of an established patient Evaluation and Management (E/M) code. Although the CPTÂŽ instructions for Evaluation and Management codes allow for working with the patient?s family/representative without the patient present, Medicare requires that the patient be personally present to report an E&M code. (By the way, we presume the patient?s ?partner? had power of attorney to enable the physician to hold this conversation in compliance with HIPAA privacy rules.)

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PARA Weekly Update: August 8, 2018

PATIENT NOT PRESENT AT VISIT

Here's an excerpt from Chapter 15 of the Medicare Benefits Policy Manual which describes covered services: https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/bp102c15.pdf Since this service would not meet Medicare?s ?in person? standard, the only means of collecting is to ask the patient/family/representative to pay for the non-covered service. We would recommend an Advance Beneficiary Notice for that purpose.

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PARA Weekly Update: August 8, 2018

CANCER RELATED FATIGUE

Some cancer patients develop a condition known as Cancer Related Fatigue following treatment. We would like to better understand, from a reimbursement/coverage standpoint, if this is a condition that is routinely covered by insurance companies. We have patients who could benefit from physical/occupational therapy for treatment of this condition. The ICD-10 code is R53.0 and became effective October 1, 2017. The coverage would typically be for PT/OT. Can PARA help with this?

Answer: We checked Medicare coverage for Cancer Related Fatigue under the LCD for Outpatient Physical Therapy (L34428) at the following link ? ICD10 code R53.0 is not covered for therapy services such as 97110 or 97530. The only covered diagnosis in the R5 range is R51, Headache: https://www.cms.gov/medicare-coverage-database/details/lcd-details.aspx?LCDId=34428&ver= 45&CoverageSelection=Local&ArticleType=All&PolicyType=Final&s=North+Carolina&CptHcpcsCode= 97110&bc=gAAAACAAAAAA& We found the same non-coverage for R53.0 on the LCD for Outpatient Occupational Therapy (L34427) at this link: https://www.cms.gov/medicarecoverage-database/details/lcddetails.aspx?LCDId=34427&ver= 51&CoverageSelection=Local &ArticleType=All&PolicyType=Final&s=North+Carolina&CptHcpcsCode=97110&bc=gAAAACAAAAAA& However, evaluations under both policies are not restricted by diagnosis ? if there is an order for an evaluation placed by a physician which is medically necessary in the judgment of the physician, Medicare will cover the evaluation.

Here?s an excerpt from the Occupational Therapy LCD regarding evaluations: Therapy Evaluation-CPT code 97165 (low complexity), 97166 (moderate complexity), 97167 (high complexity) and Occupational Therapy Re-evaluation (CPT code 97168).

Evaluation is a comprehensive service that requires professional skills to make clinical judgments about conditions for which services are indicated based on objective measurements and subjective evaluations of patient performance and functional abilities. Evaluation is warranted e.g., for a new diagnosis or when a condition is treated in a new setting. These evaluative judgments are essential to development of the plan of care, including goals and the selection of interventions. The time spent in evaluation does not count as treatment time.

We are unable to ascertain whether any other payers would cover R53.0. Medicare sometimes has medical necessity standards which exceed commercial payer requirements, and sometimes commercial payors will be more restrictive than Medicare (for instance, breast tomosynthesis.) That being said, it is usually a safe bet to follow Medicare?s lead on medical necessity standards.

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PARA Weekly Update: August 8, 2018

TESTICULAR IMPLANT PROSTHESIS

We have a patient's encounter that was coded 54660. He had bilateral testicular prosthesis implanted. HCPCS code C2622 (penile prosthesis) was used by the operating room with a quantity of two. We have an edit stating that obviously only one can be billed. We do not think the above code is the correct one to use for testicular prosthesis.

Do you know what is the correct HCPCS code is for the implant itself?

Answer: We agree, C2622 (prosthesis, penile, non-inflatable) is not the appropriate HCPCS to report for testicular implants required for the surgery 54660 (insertion of testicular prosthesis (separate procedure)).

Some ?device-dependent? surgical procedures will not pass billing edits if a device code is not present. Medicare created HCPCS C1889 (Implantable/insertable device for device intensive procedure, not otherwise classified) to satisfy the billing edit in cases where there is not an appropriate HCPCS to describe the implant. Reporting C1889 will enable the claim to pass billing edits in such cases.

In this case, billing 2 units of C1889 should resolve the problem. The MUE for C1889 is 2:

Device-dependent HCPCS are those for which Medicare deems that more than 40% of the OPPS reimbursement for that code is attributed to device cost. The list of device-dependent HCPCS is provided in Addendum P of the 2018 OPPS Final Rule.

Procedure 54660 is on the device-intensive list because it has an implant expense of 43.13% (as listed on the Addendum P), which exceeds Medicare?s 40% threshold for ?device-dependent? surgical procedures. Therefore, in this case, we recommend reporting C1889 for the implants.

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PARA Weekly Update: August 8, 2018

PARA'S SHARE OF COST ESTIMATOR: HOW IT WORKS

The rise of high-deductible health plans, the emphasis on healthcare price transparency, and cost-sharing is driving more and more healthcare consumers to seek out price information. Both insured and uninsured consumers are concerned about affordability, and providers are under increased pressure to play a bigger role in helping patients financially plan for services.

That's why PARA developed solutions for hospitals to quote charges and out-of-pocket share of cost.

Here are some examples: Charge Quote ? desktop application Outpatient - Share of cost - self-pay with a 40% discount = $3,059.30

For more information and a demonstration of these new calculators, please contact Violet Archuleta-Chiu, Senior Account Executive varchuleta@para-hcfs.com (800) 999-3332, ext. 219

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PARA Weekly Update: August 8, 2018

PARA'S SHARE OF COST ESTIMATOR: HOW IT WORKS

Charge Quote ? desktop application Outpatient - Share of cost ? high deductible managed care plan = $3,266.80

Charge Quote ? desktop application Outpatient - Share of cost ? Medicare (deductble and co-insurance) = $374.59

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PARA Weekly Update: August 8, 2018

PARA'S SHARE OF COST ESTIMATOR: HOW IT WORKS

Out-Of-Pocket ? Estimator ? Web page application

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PARA Weekly Update: August 8, 2018

PARA'S SHARE OF COST ESTIMATOR: HOW IT WORKS

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PARA Weekly Update: August 8, 2018

PARA'S SHARE OF COST ESTIMATOR: HOW IT WORKS

Outpatient - Share of cost ? high deductible managed care plan = $3,841.32

More on next page

For more information and a demonstration of these new calculators, please contact Sandra LaPlace, Account Executive slaplace@para-hcfs.com (800) 999-3332, ext. 225 11

PARA Weekly Update: August 8, 2018

PARA'S SHARE OF COST ESTIMATOR: HOW IT WORKS Outpatient - Share of cost - self-pay with a 40% discount = $2,882.64

Outpatient - Share of cost ? Medicare (deductible and co-insurance) = $374.59

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PARA Weekly Update: August 8, 2018

TECHNICAL CHANGE TO INPATIENT ORDERS RULE FOR 2019 IPPS

edicare published the 2019 Inpatient Prospective Payment System Final Rule at the link below: https://s3.amazonaws.com/public-inspection.federalregister.gov/2018-16766.pdf Among other changes in the Final Rule, Medicare provided new latitude for claim auditors in enforcing the IPPS requirement for signed and dated physician order to admit the patient to inpatient status by changing the language of regulations at 42 C.F.R. § 412.3(a). The language that Medicare will delete in the Code of Federal Regulations appears in strikethrough below: https://www.gpo.gov/fdsys/pkg/CFR-2013title42-vol2/pdf/CFR-2013-title42-vol2sec412-3.pdf § 412.3 Admissions. (a) For purposes of payment under Medicare Part A, an individual is considered an inpatient of a hospital, including a critical access hospital, if formally admitted as an inpatient pursuant to an order for inpatient admission by a physician or other qualified practitioner in accordance with this section and §§ 482.24(c), 482.12(c), and 485.638(a)(4)(iii) of this chapter for a critical access hospital.

This physician order must be present in the medical record and be supported by the physician admission and progress notes, in order for the hospital to be paid for hospital inpatient services under Medicare Part A. In addition to these physician orders, inpatient rehabilitation facilities also must adhere to the admission requirements specified in § 412.622 of this chapter.

Based on the proposal to change the regulatory language in the IPPS proposed rule for 2019, providers were optimistic that Medicare?s new regulation would permit hospitals to report services lacking an order to admit, but which otherwise qualify for inpatient status as inpatient admissions, and an inpatient encounter reimbursed under Part A. However, the final rule falls far short of providing the full extent of relief providers had hoped to gain.

The responses provided by CMS to questions submitted by commenters indicate that the new language is intended primarily to allow medical review auditors more latitude in allowing payment under Part A if the physician order is incomplete in some technical respect, so long as the rest of the documentation in the medical record appears to support the physician?s intent to admit to inpatient status.

In its responses to commenters on the proposed rule, CMS clearly does not invite hospitals to relax their current processes for obtaining a physician order as a condition of submitting a claim for inpatient reimbursement. Specifically, commenters asked if the new language allows for billing an inpatient-only procedure performed before the order to be an inpatient is placed as an inpatient claim, provided that the intent of the physician was to admit the patient; CMS did not fully understand this question, and therefore stated it would not address that comment.

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PARA Weekly Update: August 8, 2018

TECHNICAL CHANGE TO INPATIENT ORDERS RULE FOR 2019 IPPS

Commenters also questioned whether an outpatient stay could retroactively be deemed to be an inpatient stay (no); whether condition code 44 would continue to be required (CMS declined to address); and whether the new rule would be retroactive (no, it will not take effect until 10/1/18.)

Here are excerpts from the section of the Final Rule which addresses this change, pages 1390 to 1407: ?? Common technical discrepancies consist of missing practitioner admission signatures, missing co-signatures or authentication signatures, and signatures occurring after discharge. We have become aware that, particularly during the case review process, these discrepancies have occasionally been the primary reason for denying Medicare payment of an individual claim. In looking to reduce unnecessary administrative burden on physicians and providers and having gained experience with the policy since it was implemented, we have concluded that if the hospital is operating in accordance with the hospital CoPs, medical reviews should primarily focus on whether the inpatient admission was medically reasonable and necessary rather than occasional inadvertent signature documentation issues unrelated to the Common technical discrepancies consist of missing practitioner medical necessity of admission signatures, missing co-signatures or authentication the inpatient stay. It signatures, and signatures occurring after discharge have become was not our intent when we finalized the occasionally been the primary reason for denying payment. admission order documentation requirements that they should by themselves lead to the denial of payment for medically reasonable and necessary inpatient stays, even if such denials occur infrequently. ?Therefore, in the FY 2019 IPPS/LTCH PPS proposed rule (83 FR 20447 and 20448), we proposed to revise the admission order documentation requirements by CMS-1694-F 1393 removing the requirement that written inpatient admission orders are a specific requirement for Medicare Part A payment. Specifically, we proposed to revise the inpatient admission order policy to no longer require a written inpatient admission order to be present in the medical record as a specific condition of Medicare Part A payment. Hospitals and physicians are still required to document relevant orders in the medical record to substantiate medical necessity requirements. If other available documentation, such as the physician certification statement when required, progress notes, or the medical record as a whole, supports that all the coverage criteria (including medical necessity) are met, and the hospital is operating in accordance with the hospital conditions of participation (CoPs), we stated that we believe it is no longer necessary to also require specific documentation requirements of inpatient admission orders as a condition of Medicare Part A payment. We stated that the proposal would not change the requirement that an individual is considered an inpatient if formally admitted as an inpatient under an order for inpatient admission. While this continues to be a requirement, as indicated earlier, technical discrepancies with the documentation of inpatient admission orders have led to the denial of otherwise medically necessary inpatient admission. To reduce this unnecessary administrative burden on physicians and providers, we proposed to no longer require that the specific documentation requirements of inpatient admission orders be present in the medical record as a condition of Medicare Part A payment. ?After consideration of the public comments we received, we are finalizing our proposal to revise the inpatient admission order policy to no longer require a written inpatient admission order to be present in the medical record as a specific condition of Medicare Part A payment. Specifically, we are finalizing our proposal to revise the regulation at 42 CFR 412.3(a) to remove the language stating that a physician order must be present in the medical record and be supported by the physician admission and progress notes, in order for the hospital to be paid for hospital inpatient services under Medicare Part A.?

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PARA Weekly Update: August 8, 2018

RURAL HOSPITAL PROGRAM GRANTS AVAILABLE

Rural hospitals and clinics face their own set of unique and burdensome challenges when it comes to program development, cash management and maintaining volume. That's why it's great when they can get some assistance from external funding sources.

At PARA, we've found an excellent source of funding opportunities for rural healthcare facilities.

Here are some examples.

Rural Residency Planning And Development Program Technical Assistance - Provides $800,000 for three years to promote the process of rural residencies-to-rural pipeline by assisting with the development of new rural family medicine, internal medicine, or psychiatry residency programs.

- Application Deadline: August 22,2018

Montana Mental Health Trust Funding - Provide up to $500,000 of funding for programs, services, and resources for: - The prevention, treatment, and management of serious mental illness in Montana children and adults - Training and education for law enforcement personnel and more - Application Deadline: September 14, 2018

Service Area Funding For Health Center Programs - Provides $1,000,000 for Technologies for Improving Population Health and Eliminating Health Disparities to develop partnerships between innovative small business concerns and nonprofit research institutions resulting in improving minority health and the reduction of health disparities by commercializing innovative technologies. Rural populations are included in the listed health disparities priority populations.

- Application Deadline: October 1, 2018 15

PARA Weekly Update: August 8, 2018

MLN CONNECTS

PARA invites you to check out the mlnconnects page available from the Centers For Medicare and Medicaid (CMS). It's chock full of news and information, training opportunities, events and more! Each week PARA will bring you the latest news and links to available resources. Click each link or the PDF!

Thursday, August 2, 2018 News & Announcements · SNF FY 2019 Payment and Policy Changes · IRF FY 2019 Prospective Payment System Final Rule · IPF FY 2019 Final Medicare Payment and Quality Reporting Updates · Qualified Medicare Beneficiary Program Billing Requirements FAQs · Data Element Library Webinar: Video Recording · CMS Administrator Address on Strengthening Medicare · 2018 QRDA III Implementation Guide for Eligible Professionals ? Updated · LTCH Provider Preview Reports Reissued

Provider Compliance · Ophthalmology Services: Questionable Billing and Improper Payments ? Reminder

Upcoming Events · MIPS Quality Performance Category for Year 2 (2018) Overview Webinar ? August 6 · ESRD Quality Incentive Program: CY 2019 ESRD PPS Proposed Rule Call ? August 14 · Sharing Federal Strategies to Address the Opioid Epidemic Open Door Forum ? August 15 · Physician Fee Schedule Proposed Rule: Understanding 3 Key Topics Listening Session ? August 22

Medicare Learning Network® Publications & Multimedia · Provider Minute Video: Physician Orders/Intent to Order Laboratory Services and Other Diagnostic Services - New · PECOS Technical Assistance Contact Information Fact Sheet ? Reminder · Medicare Enrollment Resources Educational Tool ? Reminder · PECOS for DMEPOS Suppliers Booklet ? Reminder View this edition as a PDF [PDF, 302KB]

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PARA Weekly Update: August 8, 2018

MEDICARE PROPOSES TO CEASE THERAPY G-CODES IN 2019

In the 2019 Medicare Physician Fee Schedule Proposed Rule, Medicare announces its intention to cease requiring functional limitation G-code reporting for physical, occupational, and speech therapy services.

Since OPPS facilities are paid for therapies under the MPFS, this change will apply to hospitals as well as independent therapy service locations.

The full text of the 2019 Medicare Physician Fee Schedule Proposed rule is available on the PARA Data Editor Advisor tab using the search phrase ?2019?:

The following are pertinent excerpts from pages 390-395 of the rule: ?? we established our functional reporting claims-based data collection strategy effective January 1, 2013 in the CY 2013 PFS final rule (77 FR 689580 through 68978) and will have been collecting these functional reporting data for the last 5 years at the close of CY 2018. ? we reviewed and analyzed the data internally but did not find them particularly useful in considering how to reform payment for therapy services as an alternative to the therapy caps. ? ?? [The Middle Class Tax Relief and Jobs Creation Act (MCTRJCA) of 2012] did not specify how long the data collection strategy should last, we do not believe it was intended to last indefinitely. ? we do not believe that collecting additional years of functional reporting data in this reduced format would add utility to our data collection efforts. ?After consideration of these comments on the RFI along with a review of all of the requirements under section 3005(g) of MCTRJCA, and in light of the recent statutory amendments to section 1833(g) of the Act, we have concluded that continuing to collect more years of these functional reporting data, whether through the same or a reduced format, will not yield additional information that would be useful to inform future analyses, and that allowing the current functional reporting requirements to remain in place could result in unnecessary burden for providers of therapy services without providing further benefit to the Medicare program in the form of additional data. ?As a result, we are proposing to discontinue the functional reporting requirements for services furnished on or after January 1, 2019. ? ?If finalized, our proposal would end the requirements for the reporting and documentation of functional limitation G-codes (HCPCS codes G8978 through G8999 and G9158 through G9186) and severity modifiers (in the range CH through CN) for outpatient therapy claims with dates of service on and after January 1, 2019. Accordingly, with the conclusion of our functional reporting system for dates of service after December 31, 2018, we would delete the applicable non-payable HCPCS G-codes specifically developed to implement that system through the CY 2013 PFS final rule with comment period (77 FR 68598 through 68978). ?We are seeking comment on these proposals.?

Comments on the Proposed Rule will be accepted by CMS prior to 5 PM EST on September 24, 2018.

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PARA Weekly Update: August 8, 2018

CMS PROVIDER MINUTE VIDEO

Proper physician orders are important to providers and their patients.

In this video find out how physician orders affect patient care/services, claim payment, and medical review in the Provider Minute: Physician Orders/Intent to Order Laboratory Services and Other Diagnostic Services .

Learn about: - Importance of legible signed orders - Signed orders versus Intent to Order Services - Documentation of Medical Necessity

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PARA Weekly Update: August 8, 2018

PARA INTRODUCES NEW OUTPATIENT OUTMIGRATION REPORTS In their continuing expansion of product lines critical to streamlining hospital data collection and improving decision support tools for Chief Executive Officers, Chief Financial Officers and Business Development executives, PARA Analytics introduces the new Outpatient Migration Report.

Among other items, PARA customers using this vital report will be able determine where patients in their primary and secondary service areas are going for outpatient services, total volumes of selected outpatient services and the value of these services.

The Outpatient Migration Report provides information on Medicare Outpatient Visits and the patient?s county of residence. The source of this information is the Medicare Outpatient Limited Data Set. For the selected hospital, the top ten counties are identified based on the number of outpatient visits from those counties of residence. These counties are listed horizontally across an easy-to-read report.

All facilities that had an outpatient visit from the selected hospital?s home county are listed vertically on the report and it then details how many outpatient visits to each facility originated from each of the ten corresponding counties.

The Outpatient Migration Report includes ten tabs with this same format. The first tab includes statistics on all outpatient visits. The subsequent nine tabs include the visit counts that have been identified as specific visit types.

These include: - Emergency, Mammography - CT - MRI - Therapy - GI - Diagnostic Radiology - Lab, and - Wound Care The final tab provides reference information on how outpatient visits are assigned to the preceding categories. If any of the listed codes appear on the claim, then the visit is assigned the corresponding label.

PARA Analytics is the first national healthcare financial firm to develop such valuable reports in a more timely manner than data typically available from public sources. Using PARA?s proprietary algorithms in the PARA Data Editor, PARA can rapidly produce relevant and functional reports.

For more information and a demonstration of these new reports, please contact PARA Account Executives: Violet Archuleta-Chiu, Senior Account Executive varchuleta@para-hcfs.com (800) 999-3332, ext. 219 Sandra LaPlace, Account Executive slaplace@para-hcfs.com (800) 999-3332, ext. 225 19

PARA Weekly Update: August 8, 2018

There were FOUR new or revised Med Learn (MLN Matters) articles released this week.

To go to the full Med Learn document simply click on the screen shot or the link.

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FIND ALL THESE MED LEARNS IN THE ADVISOR TAB OF THE PDE

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PARA Weekly Update: August 8, 2018

The link to this Med Learn MM10880

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PARA Weekly Update: August 8, 2018

The link to this Med Learn MM10899

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PARA Weekly Update: August 8, 2018

The link to this Med Learn MM10559

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PARA Weekly Update: August 8, 2018

The link to this Med Learn MM10839

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PARA Weekly Update: August 8, 2018

There were ELEVEN new or revised Transmittals released this week.

To go to the full Transmittal document simply click on the screen shot or the link.

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FIND ALL THESE TRANSMITTALS IN THE ADVISOR TAB OF THE PDE

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PARA Weekly Update: August 8, 2018

The link to this Transmittal R245BP

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PARA Weekly Update: August 8, 2018

The link to this Transmittal R2101OTN

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PARA Weekly Update: August 8, 2018

The link to this Transmittal R2102OTN

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PARA Weekly Update: August 8, 2018

The link to this Transmittal R2104OTN

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PARA Weekly Update: August 8, 2018

The link to this Transmittal R2108

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PARA Weekly Update: August 8, 2018

The link to this Transmittal R4096CP

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PARA Weekly Update: August 8, 2018

The link to this Transmittal R4098CP

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PARA Weekly Update: August 8, 2018

The link to this Transmittal R4100

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PARA Weekly Update: August 8, 2018

The link to this Transmittal R4104CP

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PARA Weekly Update: August 8, 2018

The link to this Transmittal R4105CP

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PARA Weekly Update: August 8, 2018

The link to this Transmittal R4107CP

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PARA Weekly Update: August 8, 2018

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