Physician Practices Follow These Steps To Enter The E-Prescribing Era

Find out what percentage bonus you will get fromyour state. Step 2: Bill 1 of the denominator
Medicare.codesYour first step is to report one of the
Can your physician do without adoptingfollowing denominator codes: E/M service codes
e-prescribing? If your practice still has not applied99201-99205 and 99211-99215; Outpatient
electronic prescription processes, then you couldconsultation codes 99241-99245; or G codes
be missing out on two percent MedicareG0108 (Diabetes outpatient self-management
bonus— as well as preventing prescriptiontraining services, individual, per 30 minutes) or
errors and lowering consumer costs. Here areG0109 (Diabetes selfmanagement training
three simple steps to guarantee an easyservices, group session [two or more], per 30
transition.minutes).You need to report any of these codes
Backdrop: Payers and health plans havepushed foron the claim for each patient visit during the
new incentives for electronic prescription last year.reporting period that meets the denominator
For example, starting January 2009, Medicare hascoding criteria. Step 3: Report G8443-G8446 as
paid physicians a bonus if they swapped theirthe numerator: If your practice operates a
prescription pads over to e-prescribing. Variousqualified e-prescribing system, report one of the
private health plans have also offered additionalfollowing G codes on more than 50 percent of
payments along with free equipment (i.e., digitalapplicable Medicare cases for the numerator:
handheld devices).G8443 — All prescriptions formed during the
There is free software available courtesy ofencounter were generated by means of a
technology companies, given away to encouragequalified e-prescribing system G8445 — No
physicians to take the electronic route. Keep inprescriptions were generated during the
mind that free software usually provides whatencounter, but the provider does have access to
you paid for it. For example, there's little to noa qualified e-prescribing system G8446 — The
support or training when you sign up for freeprovider does have access to a qualified
solutions.e-prescribing system, but some or all prescriptions
According to Web sources, the number ofgenerated during the encounter were printed or
physicians prescribing medicines electronically hasphoned in as called for by state or federal law or
more than doubled in the last year to aboutregulations, patient request, or pharmacy system
70,000, or about 12 percent of all office-basedbeing unable to get electronic transmission or the
physicians. The increase is credited mainly to theprescription was not e-prescribed since it was for
incentives introduced at the start of the year. Donarcotics or other controlled substances.
not be among the 88 percent still holding out inRemember that the applicable "G" code must go
2010 while throwing out two percent of youron the same claim as the "denominator" service.
Medicare income and perhaps other bonuses fromFor instance: A Medicare patient visits the doctor
private payers.for chronic serous otitis media. At the end of the
Step 1: Ask yourself what e-scribing systemE/M service, the physician prescribes an antibiotic
you're usingthrough e-prescribing. Here's how you should
Before you get going, it's significant to askreport the service: 99213 (Office or other
yourself if you want to practice e-prescribingoutpatient visit …) linked to 381.01 (Acute serous
using a stand-alone system or one that is part ofotitis media) G8443. Likewise, a patient visits the
an EHR (electronic health records). According todoctor for a cold, fearing that it may involve a
Barbara J Cobuzzi, MBA, CPC, CENTC, CPC-H,sinus infection. The doctor determines that the
CPC-P, CPC-I, CHCC, president of CRN Healthcarepatient is just suffering from a cold, but, and
Solutions in Tinton Falls, N.J., you should measureorders only over-the-counter preparations. As the
the pros and cons, as follows:physician writes no prescriptions, here's how you
Stand-alone systems are the least expensive andshould bill the visit (a level 2): 99212(Office or
they're the quickest to implement, however EHRsother outpatient visit …) linked to 460 (Acute
have added features that are helpful in managingnasopharyngitis) G8445. Finally, a patient has
a medical practice over the long run. Stand-aloneschronic migraines owing to his chronic frontal
will allow the practice to be up in time for 2010 tosinusitis. The doctor documents a level 4 service.
maximize the bonus. Stand-alone systems mayHe orders some prescriptions via escribing, and
have the capacity to interface with a PM or EHRthe physician writes a manual script for Vicodin on
system. The practice can then convert from aa paper script, as it is a controlled substance. You
stand-alone system to an integrated systemshould go for: 99214 (Office or other outpatient
when an EHR is implemented, providing thevisit …) linked to 473.1 (Chronic sinusitis; frontal)
practice the best of both worlds, speedyG8446. Reap the rewards of e-prescribing One
implementation of e-prescribing and finally theadvantage of electronic prescribing is that it allows
benefits of an integrated system with anphysicians to transmit prescriptions through a
electronic health record.CMS's acting administratorsecure Internet network, through a clearinghouse,
Kerry Weems had earlier anticipated the cost ofand finally to the pharmacies using an office or
an e-prescribing system to be about $3,000 perlaptop computer or a digital handheld device.
prescriber. To add to it, practices will faceVarious studies have shown that e-prescribing
recurring costs for the dedicated internet line andreduces prescription errors and brings down costs
maintenance that the systems require, whichfor consumers and providers. That apart,
could cost you between $80 and $400 perMedicare released the new incentive guideline,
month. The good news is: You don't have to havewhich reads: "Physicians who adopt e-prescription
an EMR (electronic medical record) system tosystems are entitled to bag a bonus of 2 percent
e-prescribe. You can find stand-alone e-prescriptionof their total Medicare allowed charges." The rules
systems, like online options, that are substantiallyon how you will report your e-prescribing,
less costly than a full-blown EMR. Red flag:however, is changing in 2010. Effective January 1,
Moreover, if you are adopting e-scribing, youyou will only report an e-prescribing code when a
certainly need to check the regulatoryvisit results in an electronic prescription being
requirements of your state. Stay in touch withplaced. You will need to report this code at least
state officials and ensure you comply with any25 times during the reporting period in order to be
applicable e-prescribing requirements specific toa successful e-prescriber.