Ad Directory Existing program exemptions can


2ndMD ...........................................................45 American Physicians Insurance Company ..................................................54


Ardenwood Group ................................... 44 Covenant Medical Group .........................13 DaVita Labs ..................................................14 Georgetown Pulmonary Associates...59 Kindred Health ............................................15 Leichter Law............................................... 46 Lillibridge .....................................................59 Looper Reed & McGraw ..........................56 Quest Diagnostics .....................................39 Regions Mortgage ....................................69 Stillwater National Bank (SNB) ..............6 Texas Department of State Health Services HIV/STD ....................54


Texas Department of State Health Services .......................................48


Texas Health Steps........................After 40 Texas Medical Association Foundation ................................................. 3 Distance Learning Center ....................71 Health Information Technology .......63 Knowledge Center ................................69 Legislative Report Card ..........After 48 Medical Jobs Center ...........................IBC Mobile App .............................................. 64 Physician Oncology Education Program .................................................55


Policies and Procedures ......................63 Practice Consulting ...............................38 Regional Extension Centers .............40


Texas Medical Association Insurance Trust ...........................................................BC


Texas Medical Liability Trust ............... IFC Texas Mutual Insurance Company ......52 TEXPAC .........................................................56 Wave Two LLC ...........................................40


Advertise for as little as $25! TMA’s website experiences nearly 320,000 visitor sessions each month. With this kind of activity, can you afford not to advertise in TMA’s online classifieds? Place and purchase your classified ad now at http://classifieds.texmed.org.


CMS proposes new e-prescribing exemptions


The Centers for Medicare & Medicaid Services (CMS) announced proposed changes to the 2011 e-prescribing pro- gram by adding exemptions for the 2012 penalty. Texas physicians had until June 30 to e-prescribe to avoid penal- ties in 2012 (1 percent of Medicare Part B claims). If you have not started, you should. To read the proposed rule, visit www


.ofr.gov/OFRUpload/OFRData/2011- 13463_PI.pdf.


Physicians had to report e-prescribing via claims using G-code G8553 on at least 10 unique Medicare encounters by June 30 to prevent the penalty. Report at least 25 times by Dec. 31 to qualify for a 1-percent bonus of Medicare Part B claims and prevent the penalty in 2013. Follow the instructions in TMA’s


2011 e-prescribing informational paper (log on to www.texmed.org/Template .aspx?id=7354). Email HIT@texmed.org or call the TMA HIT helpline for more information at (800) 880-5720. Physicians will have an opportunity to attest through an online web portal (CMS has not yet created the URL) by Oct. 1 that they should be eligible for one of the following exemptions to avoid the 2012 e-prescribing penalty:


• Physician is registered to participate in the Medicare or Medicaid Electron- ic Health Record (EHR) Incentive Pro- gram and has adopted certified EHR technology.


• Physician is unable to electronically prescribe due to local, state, or fed- eral law or regulation.


• Physician infrequently prescribes (e.g., he or she prescribed fewer than 10 prescriptions between Jan. 1, 2011, and June 30, 2011).


• There are insufficient opportunities to report the e-prescribing measure due to program limitations.


70 TEXAS MEDICINE August 2011


TMA explains Medicare and Medicaid coding


TMA’s Payment Advocacy staff has pre- pared a free presentation to refresh phy- sicians’ understanding of how the Medi- care National Correct Coding Initiative (NCCI) edits process works. It explains the importance of billing according to the NCCI edits, includes tips for ensur- ing that your practice stays current with NCCI changes, outlines the differences among the Medicare, Medicaid, and commercial edits, and provides other helpful billing tips.


The Centers for Medicare & Medicaid


Services requires all Medicare claims to be processed against the NCCI to pro- mote accurate coding. The health system reform law required Medicaid to imple- ment the NCCI edits, as well. Texas Med- icaid did so last fall. All Medicaid claims submitted on or after Oct. 1, 2010, are subject to NCCI edits.


The edits tell you when two pro-


cedures can be reported together and when they cannot. To view the presentation, visit www .texmed.org/template.aspx?id=6342. n


Crystal Conde is associate editor of Texas Medicine. You can reach her by telephone at (800) 880-1300, ext. 1385, or (512) 370-1385; by fax at (512) 370-1629; or by email at crystal.conde@texmed.org.


be reported now by using a G-code on Medicare claims, including:


• G8642: Physician’s practice is in a ru- ral area without high-speed Internet access; and


• G8643: Physician’s practice is in an area without sufficient available phar- macies for electronic prescribing.


These changes are a result of con-


cerns expressed by physicians across the country. TMA urged CMS to revise the current e-prescribing penalties. TMA will comment on the proposed rule, urging CMS to adopt the additional exemptions.


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