| Find out what percentage bonus you will get from | | | | - E/M service codes 99201-99205 and |
| Medicare. | | | | 99211-99215; |
| Can your physician do without adopting | | | | - Outpatient consultation codes 99241-99245; or |
| e-prescribing? If your practice still has not applied | | | | - G codes G0108 (Diabetes outpatient |
| electronic prescription processes, then you could | | | | self-management training services, individual, per |
| be missing out on two percent Medicare bonus- | | | | 30 minutes) or G0109 (Diabetes selfmanagement |
| as well as preventing prescription errors and | | | | training services, group session [two or more], per |
| lowering consumer costs. Here are three simple | | | | 30 minutes). |
| steps to guarantee an easy transition. | | | | You need to report any of these codes on the |
| Backdrop: Payers and health plans have pushed | | | | claim for each patient visit during the reporting |
| for new incentives for electronic prescription last | | | | period that meets the denominator coding criteria. |
| year. For example, starting January 2009, | | | | Step 3: Report G8443-G8446 as the numerator: |
| Medicare has paid physicians a bonus if they | | | | If your practice operates a qualified e-prescribing |
| swapped their prescription pads over to | | | | system, report one of the following G codes on |
| e-prescribing. Various private health plans have | | | | more than 50 percent of applicable Medicare |
| also offered additional payments along with free | | | | cases for the numerator: |
| equipment (i.e., digital hand held devices). | | | | - G8443 - All prescriptions formed during the |
| There is free software available courtesy of | | | | encounter were generated by means of a |
| technology companies, given away to encourage | | | | qualified e-prescribing system |
| physicians to take the electronic route. Keep in | | | | - G8445 - No prescriptions were generated during |
| mind that free software usually provides what | | | | the encounter, but the provider does have access |
| you paid for it. For example, there's little to no | | | | to a qualified e-prescribing system |
| support or training when you sign up for free | | | | - G8446 - The provider does have access to a |
| solutions. | | | | qualified e-prescribing system, but some or all |
| According to Web sources, the number of | | | | prescriptions generated during the encounter were |
| physicians prescribing medicines electronically has | | | | printed or phoned in as called for by state or |
| more than doubled in the last year to about | | | | federal law or regulations, patient request, or |
| 70,000, or about 12 percent of all office-based | | | | pharmacy system being unable to get electronic |
| physicians. The increase is credited mainly to the | | | | transmission or the prescription was not |
| incentives introduced at the start of the year. Do | | | | e-prescribed since it was for narcotics or other |
| not be among the 88 percent still holding out in | | | | controlled substances. |
| 2010 while throwing out two percent of your | | | | Remember that the applicable "G" code must go |
| Medicare income and perhaps other bonuses from | | | | on the same claim as the "denominator" service. |
| private payers. | | | | For instance: A Medicare patient visits the doctor |
| Step 1: Ask yourself what e-scribing system | | | | for chronic serous otitis media. At the end of the |
| you're using | | | | E/M service, the physician prescribes an antibiotic |
| Before you get going, it's significant to ask | | | | through e-prescribing. Here's how you should |
| yourself if you want to practice e-prescribing | | | | report the service: |
| using a stand-alone system or one that is part of | | | | - 99213 (Office or other outpatient visit...) linked to |
| an EHR (electronic health records). According to | | | | 381.01 (Acute serous otitis media) |
| Barbara J Cobuzzi, MBA, CPC, CENTC, CPC-H, | | | | - G8443 Likewise, a patient visits the doctor for a |
| CPC-P, CPC-I, CHCC, president of CRN Healthcare | | | | cold, fearing that it may involve a sinus infection. |
| Solutions in Tinton Falls, N.J., you should measure | | | | The doctor determines that the patient is just |
| the pros and cons, as follows: | | | | suffering from a cold, but, and orders only |
| - Stand-alone systems are the least expensive | | | | over-the-counter preparations. As the physician |
| and they're the quickest to implement, however | | | | writes no prescriptions, here's how you should bill |
| - EHRs have added features that are helpful in | | | | the visit (a level 2): |
| managing a medical practice over the long run. | | | | - 99212(Office or other outpatient visit...) linked to |
| - Stand-alones will allow the practice to be up in | | | | 460 (Acute nasopharyngitis) |
| time for 2010 to maximize the bonus. | | | | - G8445. Finally, a patient has chronic migraines |
| - Stand-alone systems may have the capacity to | | | | owing to his chronic frontal sinusitis. The doctor |
| interface with a PM or EHR system. | | | | documents a level 4 service. He orders some |
| - The practice can then convert from a | | | | prescriptions via escribing, and the physician writes |
| stand-alone system to an integrated system | | | | a manual script for Vicodin on a paper script, as it |
| when an EHR is implemented, providing the | | | | is a controlled substance. |
| practice the best of both worlds, speedy | | | | You should go for: |
| implementation of e-prescribing and finally the | | | | - 99214 (Office or other outpatient visit...) linked to |
| benefits of an integrated system with an | | | | 473.1 (Chronic sinusitis; frontal) |
| electronic health record. | | | | - G8446. |
| CMS's acting administrator Kerry Weems had | | | | Reap the rewards of e-prescribing |
| earlier anticipated the cost of an e-prescribing | | | | One advantage of electronic prescribing is that it |
| system to be about $3,000 per prescriber. To | | | | allows physicians to transmit prescriptions through |
| add to it, practices will face recurring costs for | | | | a secure Internet network, through a |
| the dedicated internet line and maintenance that | | | | clearinghouse, and finally to the pharmacies using |
| the systems require, which could cost you | | | | an office or laptop computer or a digital handheld |
| between $80 and $400 per month. | | | | device. Various studies have shown that |
| The good news is: You don't have to have an | | | | e-prescribing reduces prescription errors and |
| EMR (electronic medical record) system to | | | | brings down costs for consumers and providers. |
| e-prescribe. You can find stand-alone e-prescription | | | | That apart, Medicare released the new incentive |
| systems, like online options, that are substantially | | | | guideline, which reads: "Physicians who adopt |
| less costly than a full-blown EMR. | | | | e-prescription systems are entitled to bag a bonus |
| Red flag: Moreover, if you are adopting e-scribing, | | | | of 2 percent of their total Medicare allowed |
| you certainly need to check the regulatory | | | | charges." The rules on how you will report your |
| requirements of your state. Stay in touch with | | | | e-prescribing, however, is changing in 2010. |
| state officials and ensure you comply with any | | | | Effective January 1, you will only report an |
| applicable e-prescribing requirements specific to | | | | e-prescribing code when a visit results in an |
| your state. | | | | electronic prescription being placed. You will need |
| Step 2: Bill 1 of the denominator codes | | | | to report this code at least 25 times during the |
| Your first step is to report one of the following | | | | reporting period in order to be a successful |
| denominator codes: | | | | e-prescriber. |