MNT Provider - April 2014

MNT Provider Your source for practice management news

April 2014 | Volume 12 | Number 12

Medicare fee-for service payment cuts averted, ICD-10 delayed and more

facility value-based purchasing (SNF VBP) program to apply to services furnished on or after Oct. 1, 2018. The concept of value-based pur- chasing (VBP) was introduced by CMS as a payment methodology for hospital services in fiscal year 2013. This payment methodol- ogy links provider payments to improved performance by health ICD-10 basics free webinar available on demand....................................... 3 Is your patient health data secure?............................................. 3 Inside: Medicare fee-for service payment cuts averted, ICD-10 delayed and more................................................. 1 Reminder: Deadline for new CMS 1500 claim form. ............................. 1 Spanish version of the model Notice of Privacy Practices available......... 2 Watch what you copy and paste.... 2 Question Corner............................... 3

the subject of continued Congres- sional deliberation over the coming months. The Act also delays the transition to ICD-10. A seven-line section of the Act states that the Department of Health and Human Services (HHS) cannot adopt the ICD-10 code set as the standard “until at least” Oct. 1, 2015. The Centers for Medicare & Medicaid Services (CMS) have not yet identified plans to implement the law. CMS spokeswoman Rachel Maisler said earlier this month, “We are examining the legislation and will provide guidance to provid- ers and other stakeholders soon.” RDNs should continue to submit reimbursement claims using ICD-9 codes. Additionally, RDNs should watch future issues of the MNT Provider for updated information on the transition to ICD-10 once CMS provides further direction. Although the Act includes numerous Medicare payment and policy changes that do not directly pertain to dietetics, RDNs will be interested in a provision for the establishment of a skilled nursing

On April 1, 2014, President Obama signed into law H.R. 4302: Protect- ing Access to Medicare Act of 2014 (the Act). Most notably, the Act includes a one-year fix to the sustainable growth rate (SGR) that delays pending reimbursement cuts by one year (see sidebar on page 4). Without a fix to the SGR formula, Medicare providers, including regis- tered dietitian nutritionists (RDNs), would have faced a 24 percent cut in reimbursements beginning April 1, 2014. This temporary “doc fix” extends the 0.5 percent update to the 2015 Medicare Physician Fee Schedule (MPFS) for services pro- vided through Dec. 31, 2014, and also provides a 0 percent update to the 2015 MPFS for services pro- vided from Jan. 1, 2015, through March 31, 2015. As a result, fees for RDNs and other Medicare providers paid under the MPFS will remain at current rates through March 31, 2015. This short-term patch does not mean the end of Congressional debate over the SGR repeal. A per- manent solution to SGR and Medi- care payment reform will remain

See Cuts averted , page 4

Starting April 1, 2014, all paper claims to third-party payers must be submitted on the revised CMS 1500 claim form (version 02/12). Notably, the revised form adds the ability to indicate whether you are using ICD-9-CM or ICD-10-CM diagnosis codes and expands the number of diagnosis codes from four to twelve. Copies of the form may be downloaded but must be printed to exact standards, including the type and color of ink, as the form is built to be scanned using OCR technol- ogy. For more information, read the January 2014 MNT Provider at: www. eatright.org/mntprovider or visit the National Uniform Claim Committee’s website: www.nucc.org. To view a sample CMS 1500 claim form (ver- sion 02/12), visit: www.eatright.org/ Members/content.aspx?id=7308. April 1 deadline for new CMS 1500 claim form

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