EyeCOR News
New EyeCOR Update for 2011 - Modifiers and Drug Reference Changes (30 April 2011)
New Updates effective April 30, 2011.
New Coding Changes
- This update continues with changes for several regions that have
updated their LCDs.
Medications - Additional medications have been added to the
Ophthalmic Drug Reference.
Modifiers
- Updated and expanded information regarding
the use of Modifiers. This can be found in the Ophthalmic Reference
- Procedure Code Modifiers.
New EyeCOR Update for 2011 - Nursing Home Changes (28 March 2011)
New Updates effective March 28, 2011.
Scanning Laser Codes – This update continues with changes for several regions that have updated their policy on the new Scanning Laser codes.
Updated PQRS – Additional changes to PQRS are in this version.
New Coding Changes – There have been additional changes in several regions.
Nursing Home
–
Update shows more information regarding the regulations,
requirements and minimum time requirements for Nursing Home and
Extended
Care Facilities.
New EyeCOR Update for 2011 - PQRS Changes (8 March 2011)
New Updates effective March 8, 2011.
Scanning Laser Codes
–
There are many
continuing issues with the new scanning laser codes adopted this
year. In the previous version we highlighted
these issues. Most payers still have not correctly updated their
local rules. They still have posterior procedures supported by
anterior diagnoses and vice versa. We have highlighted the in
correct procedures in red and shown they are not appropriate.
Updated PQRS
– Additional changes to PQRS (formally PQRI) are shown in this
version.
New Coding Changes
– There have been
additional changes in several regions.
New EyeCOR Update for 2011 - Very Important Changes (1 January 2011)
We have posted a new EyeCOR update. This update is for all changes effective 2011.
Some of the important changes:
New 2011 fees - These fees are effective 1/1/2011. However, throughout the year Medicare and the other insurance companies continually change their fees. This is why it is important to get the continuous EyeCOR updates when they are available.
PQRS Changes - First CMS has changed the nomenclature to Physicians Quality Reporting System (PQRS).
Second there are many changes to the PQRS codes, their measurements as well as allowed modifiers. This version has all the current 2011 codes and their reporting requirements.
Note: We have seen several blogs and articles about obtaining additional and easy reimbursement for Tobacco PQRIs. As of 2011, all of the Tobacco PQRS codes have been deleted!
New Codes - There are several new procedure codes that have gone into effect in 2011. Some replace old and very common codes that are no longer valid.
The most affected code that has been deleted is 92135 – Scanning Laser. This is the code used for OCT, HRt and GDx. The replacement codes are 92132, 92133 and 92134. These are now for specific segments of the eye. Most payers have not updated their LCDs for these new codes. However, they are expected to quickly change the supporting diagnoses.
The supporting diagnoses will be different for each of the three codes!
As usual as soon as new LCDs are published, EyeCOR will be updated.
Note: we have seen many online sources, lists and blogs asking and giving advice about the new Scanning Laser codes. Be very careful, most of the information we have seen is incorrect!
Make sure you look up the new codes in EyeCOR for full information.
President Obama Signs the Medicare and Medicaid Extenders Act of 2010 (21 December 2010)
On Wednesday, December 15, 2010 President Obama signed into law the Medicare and Medicaid Extenders Act of 2010 (MMEA). This new law prevents a scheduled payment cut for physicians who treat Medicare patients from taking effect. The Extenders Act of 2010 prevents a payment cut for physicians that would have taken effect on January 1, 2011. While the physician fee schedule update will be zero percent, other changes to the relative value units (RVUs) used to calculate the fee schedule rates must be budget neutral. To make those changes budget neutral, the conversion factor must be adjusted for 2011. CMS is currently developing the 2011 Medicare Physician Fee Schedule (MPFS) to implement the zero percent update, and it is expected that all 2011 claims will be processed timely, in compliance with the new legislation.
Replacement of the 92135 Scanning Laser CPT Code (12 December 2010)
On 1 January 2011, the code for Scanning Laser will be retired and no longer valid. This will be replaced by three different CPT codes that distinguish between the various regions of the eye. The three new codes to replace the old 92135 are:
92132 - Scanning computerized ophthalmic diagnostic imaging, Anterior Segment
92133 - Scanning computerized ophthalmic diagnostic imaging, Posterior Segment - Optic Nerve
92134 - Scanning computerized ophthalmic diagnostic imaging, Posterior Segment - Retina
In most aspects the usage for these new codes is the same as with the old 92135.
They are for all forms of Scanning laser (OCT, GDx and HRT).
They are all mutually exclusive from each other as well as from 92250 Fundus, 92225-92226 Extended Ophthalmoscopy and 92285 External Photos
They all require an Interpretation and Report
There is one notable difference with the new codes:
They all have changed from Unilateral to Unilateral or Bilateral. This means you can no longer bill for each eye.
These new codes go into effect Jan 1st 2011 and the old code 92135 will no longer be valid.
Basically these new codes replace and further define their usage by three segments of the eye; Anterior, Posterior (Optic Nerve) and Posterior (Retina)
PECOS UPDATE
(26 November 2010)
This statement was issued on November 26, 2010 by The Centers
for Medicare & Medicaid Services (CMS):
It was previously announced that, beginning January 3, 2011,
if certain Part B billed items/services require an
ordering/referring provider NPI and the ordering/referring provider
NPI is not on the claim, is not of a profession that is permitted to
order/refer, or does not have an enrollment record in the Medicare
Provider Enrollment, Chain and Ownership System (PECOS), the claim
will not be paid.
However, the automated edits will NOT be turned on effective
January 3, 2011. CMS is working diligently to resolve PECOS
enrollment backlogs and other system issues and will provide ample
advanced notice to the provider and beneficiary communities before
beginning any automatic nonpayment actions.
EyeCOR Integrated with EMR / EHR systems (20 April 2010)
EyeCOR is integrated with several EHR and Practice Management Systems.
Exam Verification The first phase is Exam Verification. EyeCOR has always shown all the requirements for satisfying each level of an exam. Now in your EHR system you can click on the "EyeCOR Exam Verification" button. Your EHR will immediately link to EyeCOR's Verification screen showing if you have satisfied all requirements of the exam. EyeCOR verifies all four 92xxx Ophthalmic exams as well as all ten levels for the 92xxx E/M exams.
ICD and CPT codes As you may know most practice management systems do not have all the codes and incorrect descriptions. EyeCOR has all codes and shows the actual AMA descriptions. Another interface is where EyeCOR can automatically update your Practice Management System with all the codes and their correct description.
Many Practice Management System / EHR vendors have already completed or in the process of the interface. Others have signed agreements or express interest in integrating with EyeCOR. Almost all vendors are at some stage or planning on the interface. These vendors are aware of the value of the information in EyeCOR and the amount of research and effort our staff puts into keeping this information accurate and up to date. These vendors realize we are best suited for this and want their users to take full advantage of our expertise.
Welcome Danielle
We would like to introduce our newest Coding Specialist...
Danielle Andrews was hired this past week and is a great addition to the EyeCOR team. She, as well as the rest of our staff, is a valuable resource to you, our users.
Danielle's email address is dandrews@nteon.com
Please join us in welcoming Danielle - Say “hello” next time you call or drop her an email.
Office Hours
Our office hours currently are Monday through Thursday 8:00 AM to 7:00 PM EST - Fridays from 8:00 AM to 5:00 PM EST.
Soon we will be expanding our Friday hours until 7:00 PM EST. These extended hours will help our west coast clients.
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