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E-News for Office Staff  August 1, 2011

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Colorado Medical Society Health Care Financing Division

PHONE: (720) 858-6321

FAX: (720) 859-7509
Register TODAY for free provider call on ICD-10 implementation strategies
Is your office preparing for a smooth transition to ICD-10 on Oct 1, 2013? 

The Centers for Medicare and Medicaid Services will host a National Provider Call on "ICD-10 Implementation Strategies for Physicians" from 11 a.m. to 1 p.m. (MST) on Wednesday, Aug. 3.

CMS subject matter experts will discuss ways that physician offices can prepare for the change to ICD-10 for medical diagnosis and inpatient procedure coding.
To receive call-in information, you must register by 11 a.m. on Aug. 2.

For more information and to register, click here.  More information about ICD-10 is available here.  
Medicaid EHR incentive program to roll out soon 

(From CORHIO Connect)  


CORHIO will assist Colorado's Department of Health Care Policy & Financing as it implements the Medicaid Electronic Health Record (EHR) Incentive Program.

The program will provide incentive payments to eligible providers as they adopt, implement, upgrade or demonstrate "meaningful use" of certified EHR technology.

Read more in this story from the CORHIO CONNECT electronic newsletter. You will also find more information on the EHR incentive program, including whether you qualify for the Medicaid incentive, and links to resources from CORHIO and CO-REC. 


PECOS: Still time to enroll
The Centers for Medicare and Medicaid Services has not released an update on when it will begin denying claims for services ordered or referred by providers not enrolled in the PECOS system.

If you have not already done so, there is still time to enroll and you should do so now.

If you are not not sure whether you are properly enrolled, click here to learn how to obtain this information. This page also includes a link to the online PECOS enrollment page and other PECOS-related information.

CMS is currently working to address a backlog and other issues and has said it will provide ample notice before automatic claims denials begin. 
Recent payer newsletters




Version 5010 testing week  

The Version 5010 compliance date - Sunday, Jan. 1, 2012 - is fast approaching.  All HIPAA covered entities should be taking steps now to get ready, including conducting external testing to ensure timely compliance. 


To assist in this effort, the Centers for Medicare & Medicaid Services (CMS), in conjunction with the Medicare FFS Program, announce a National 5010 Testing Week to be held Monday, Aug. 22 through Friday, Aug 26.   


This is an opportunity for trading partners to come together and test compliance efforts that are already underway with the added benefit of real-time help desk support and direct and immediate access to TrailBlazer. CMS encourages all trading partners to participate in the National 5010 Testing Week, including:

  • Providers;
  • Clearinghouses; and
  • Vendors.


Trading partners must register in advance with TrailBlazer. Access the online registration here or get more information on TrailBlazer's 5010 web page.  


You may also check out CMS' 5010 web page, which includes more information and educational resources.


Note that successful testing is required before a trading partner may be placed into production!

Proposed rules aimed at creating new type of health plan
The U.S. Department of Health and Human Services recently proposed rules for establishing a new type of private, non-profit health insurance called a Consumer Operated and Oriented Plan, or CO-OP.

CO-OPs are designed to provide affordable, quality and consumer-friendly health insurance in every state. The plans would be available to consumers and small businesses through a state's health insurance exchange. They would have a board made up of members - giving consumers more of a say in their health plan - and profits would be used to benefit enrollees.

Colorado Medical Society President Michael Pramenko, MD, is a member of the 15-person national CO-OP Advisory Board that is helping shape the CO-OPs and to make recommendations on the awarding of grants and loans for the program.  

You may read more about CO-OPs in this fact sheet from or on the Centers for Medicare and Medicaid Services' CO-OP page.
Revised ABN forms, instructions
The Centers for Medicare and Medicaid Services has revised its Advanced Beneficiary Notice of Noncoverage (ABN) form. The new form is available for immediate use. Effective Nov. 1, 2011, use of this new form will be mandatory.

More information is available on CMS' Revised ABN web page.

For a quick download of the new form, click here. For instructions, click here.

Note: These documents and other helpful links are available via the Colorado Medical Society's Resource Library. Bookmark it today!
Influenza vaccines approved 

The U.S. Food and Drug Administration has approved the influenza vaccine formulation for the 2011-2012 vaccine that will be used by the six manufacturers licensed to produce and distribute influenza vaccine for the United States.


The vaccine formulation protects against the three virus strains that surveillance indicates will be most common during the upcoming season and includes the same virus strains used for the 2010-2011 influenza season.


Between 5 percent and 20 percent of the U.S. population develops influenza each year, leading to more than 200,000 hospitalizations from related complications, according to the U.S. Centers for Disease Control and Prevention (CDC).


In addition to the role that health care providers play in recommending influenza vaccination for their patients, influenza vaccination of health care personnel is also important to protect themselves, their patients, their family, and the community from influenza. The FDA urges health care organizations to encourage their members to follow CDC's Advisory Committee on Immunization Practices (ACIP) recommendations to get vaccinated.


The brand names and manufacturers of the vaccines for the upcoming season are: Afluria, CSL Limited; Fluarix, GlaxoSmithKline Biologicals; FluLaval, ID Biomedical Corporation; FluMist, MedImmune Vaccines Inc.; Fluvirin, Novartis Vaccines and Diagnostics Limited; and Fluzone, Fluzone High-Dose and Fluzone Intradermal, Sanofi Pasteur Inc. Fluzone Intradermal, approved on May 9, 2011, will be available for those ages 18 years through 64 years. This vaccine is delivered into the skin, rather than the muscle, using a very small needle.


Find more information on vaccine safety and availabililty on the FDA's website.

About Us
The Colorado Medical Society is the largest organization of physicians in the state of Colorado. This newsletter is published by the CMS Health Care Financing Division, which works with physicians, practice managers and other office staff to help practices remain viable and thrive. If you have questions about practice viability, please visit our website or email