Learn about: ICD-10-CM and guidelines, key coding conventions for the ICD-10-CM, differences between ICD-9 and ICD-10, and diagnosis coding in ICD-10 by body part.

Target Audience: Small Practices  

Register online

Medicinal Marijuana Program Webinar

The New Jersey Department of Health's Medicinal Marijuana Program has developed an introductory webinar for physicians on their Medicinal Marijuana Program. This webinar provides information on the program and how physicians and patients can register. For answers to frequently asked questions, visit the Department's website. Physicians may also find a list of scholarly articles related to medicinal marijuana research on the Program website.

United Healthcare Community Plan Pediatric Vaccine Administration

MSNJ was recently made aware of United Healthcare Community Plan's (UHC CP) new policy to no longer pay for CPT codes 90460 and 90461 (vaccine administration with counseling for children). In a letter to participating physicians, UHC CP explained that physicians should now use CPT code 90471 to report vaccine administration for children. We believe that CPT Code 90471 does not accurately reflect the counseling provided when administering vaccines to pediatric patients.  

This week, MSNJ wrote to UHC CP expressing our concerns regarding correct coding, financial impact on physician practices, and patient access to care. We asked UHC CP to reconsider its policy and made the Medicaid program aware of our position.  In response to our concern, the Medicaid program had indicated that it is looking into the issue. MSNJ recommends that UHC CP participating providers file a formal written appeal as outlined in the UHC CP letter. Please feel free to use the sample letter that the American Academy of Pediatrics was kind enough to share for MSNJ member use.

Tavenner Confirmed by Senate to Head CMS

This week the Senate confirmed Marilyn Tavenner to head CMS. She is a former nurse and hospital administrator who has been serving as the acting CMS administrator since 2010. She is the first confirmed administrator since 2006. Read more.

Employers Not Required to Post NLRB Notice of Labor Rights

This month the U.S. Court of Appeals for the District of Columbia ruled that private -sector employers are not required to post a notice that informs employees of their right to join a union and engage in other forms of concerted activity. The court's decision addresses a controversial National Labor Relations rule issued in 2011.  The rule made an employer's failure to post the notice an unfair labor practice and evidence of anti-union animus. The court disagreed. While cases are pending in other districts private sector employers are under no obligation to post the notice at this time.

Tackling the Cost Conundrum

The May issue of Health Affairs focuses on the recent slowing in the growth of health care expenditures. The issue addresses major cost drivers in Medicare and presents proposals for putting the program on a more sustainable path. Researchers suggest that job loss and benefit changes shifting costs to the insured are two factors potentially contributing to the record slowdown in growth. Fundamental changes, including less rapid development of imaging technology and new pharmaceuticals, increased patient cost-sharing, and greater provider efficiency have led to the majority of the slowdown in health care spending growth. The May issue and all of the articles are available online.

AMA tells CMS-- EHR Implementation is Difficult--Guidance Needed

On May 3rd CMS hosted a listening session with invited guests to explore issues with EHR systems and their use. AMA Board Chair Steven Stack, MD, spoke about the problems with EHR systems, including the fact that many systems purchased by physicians were not ready for use. He commented on the institutional shift of medical record use from a record for patient treatment to a record to support billing for payment.   

Dr. Stack challenged the proposition that the use of templates, and even cutting and pasting, would be fraud indicating that these are times when even a cloned document may be appropriate if accurate and the medical services were actually rendered.  Dr. Stack also took the position that any potential increase in costs for care could be the result of better documentation and physicians being paid for the services that they always provided, but perhaps did not document in the past. In his view, this would be an indication that physicians were not being paid for all services rendered in the past.

Dr. Stack ended his comments to CMS urging it to develop appropriate guidance. Dr. Stack's comments to CMS are consistent with an MSNJ resolution that has been presented to the AMA for its consideration in June.We appreciate the initiative that AMA has taken on this important issue. Read more.   

Horizon Recruiting Practices to Join Medical Home Program

Horizon Blue Cross Blue Shield of New Jersey is recruiting primary care practices to join their Patient-Centered Medical Home (PCMH) Program. For a brief overview of the program, Horizon has prepared a three-minute video to introduce the program to practices that may be interested. For more information, you can also contact Horizon via e-mail.  

Applications Still Accepted for Hurricane Sandy Relief Grant 
The Physicians Foundation announced a grant in the amount of $350,000 each to the Medical Society of New Jersey and the Medical Society of the State of New York. Grantees do not have to be MSNJ Members. Download the application today.

• Read the NJBIZ article about the fund. 
• Read more in the Hudson Reporter. 

MSNJ Practice Management Community

ICD-10 Tip:

When submitting claims on or after the October 14, 2014 ICD-10 deadline, if the date of service was before the deadline, the ICD-9 code must be used. If the date of service is on or after October 14, 2014, ICD-10 must be used. For more information about ICD-10, join MSNJ for an informational workshop. See details below.

"ICD-10 and Coding for Difficult Diagnosis."  

Friday, June 21 from 9:00 A.M. to 12:00 P.M. at MSNJ Headquarters, Lawrenceville, NJ.

Join MSNJ for an ICD-10 workshop on "ICD-10 and Coding for Difficult Diagnosis."

Presented by: Tina Cressman, MALS, CPC, CPC-H, CPC-P, CEMC, CPMA, CPEDC, CPC-I, CCS-P, MCS-P, MCS-I, CPAT, CCAT, CCT, CMC, Assistant Director, Health Information Management, Cooper University Hospital.

Learn about: ICD-10-CM and guidelines, key coding conventions for the ICD-10-CM, differences between ICD-9 and ICD-10, and diagnosis coding in ICD-10 by body part.

Target Audience: Small Practices  

Register online