Changes in Flu Shot Codes After January 1, 2011

CMS has created specific HCPCS codes and payment allowances to replace CPT code 90658 for Medicare billing purposes for the 2010-2011 influenza season. Note that these HCPCS codes will not be recognized by the Medicare claims processing systems until January 1, 2011, when CPT code 90658 will no longer be recognized.

Q2035 (locally priced)
Afluria vacc, 3 yrs & >, im
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Afluria)

Q2036 ($7.439 national allowable)
Flulaval vacc, 3 yrs & >, im
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Flulaval)

Q2037 ($13.253 national allowable)
Fluvirin vacc, 3 yrs & >,im
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Fluvirin)

Q2038 ($12.593 national allowable)
Fluzone vacc, 3 yrs & >, im
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Fluzone)

Q2039 (locally priced)
NOS flu vacc, 3 yrs & >, im
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Not Otherwise Specified)

Annual Part B deductible and coinsurance amounts do not apply to these vaccines. All physicians, non-physician practitioners and suppliers who administer the influenza virus vaccination and the pneumococcal vaccination must take assignment on the claim for the vaccine.

Register For Medicare and Medicaid Electronic Health Record Incentives Now!

The Centers for Medicare & Medicaid Services (CMS) encourages eligible professionals, eligible hospitals and critical access hospitals to register for the Medicare and/or Medicaid EHR Incentive Program(s) as soon as possible. You can register before you have a certified EHR. Register even if you do not have an enrollment record in the Provider Enrollment, Chain and Ownership System (PECOS).
The Registration and Attestation page (click on button below) on the EHR website now contains:

Instructions to promote a smooth registration process, User guides, and a link to the registration site.

http://www.cms.gov/EHRIncentivePrograms/20_RegistrationandAttestation.asp

Transition to ICD-10 and Revision 5010 standard transactions.

It is time for all medical practices to start becoming aware of the upcoming changes that will affect all of us in 2013. We have recently returned from the HBMA National Conference. One of the largest changes to impact medical practices will be the revision 5010 standard and the adoption of ICD-10. Our offices are currently formulating training, transition, and implementation plans to better assist our client base. As details are unveiled we will be providing you with updated information regarding the ICD-10 changes and documentation requirements as well as our own preparedness for the transition to version 5010. We look forward to working with all of you on these changes. Please feel free to contact us at 1.877.543.2323 with any questions or concerns.

It is important for the health of your practice to keep a handle on the self-pay portion of your accounts receivables. A typical healthcare provider obtains 75-90% of its revenues from third party payers. This number is diminishing as healthcare costs are increasing the patient portion is also increasing. The remaining 10-25% comes from your patients. This percentage of revenue could be the determination of whether your practice is profitable or not. Or think of it another way, this could pay an employees annual salary. Have a defined collection policy for copay and self pay make sure it is in writing and that your staff and your patients understand it.
Patients do need to be educated on your practice financial policies. If they understand what you expect up front they will be more likely to comply. Let the patient know when the appointment is scheduled they need to bring their applicable copayment. This may seem like a small thing to do, but it can have a very big impact on the profitibility of your practice.
Remember, Practice Money$$ Does Matter!