Last Chance to Participate in PQRS Before Penalties Begin
Since 2007, successful participants in the Physician Quality Reporting System (PQRS) have received a bonus payment of as much as 2 percent of Medicare allowed charges. Beginning this year through 2014, qualifying participants will receive a bonus payment of 0.5 percent. However, while there may be some provisions for physicians who do not have appropriate measures to report, the vast majority of cardiologists will likely be subject to a penalty starting in 2015. Also, the Centers for Medicare and Medicaid Services (CMS) will assess the penalty similar to the e-prescribing penalty, meaning penalties will be based on participation prior to the year in question. For example, physicians who do not participate in PQRS in 2013 will be subject to the 2015 penalty. To help members understand the PQRS participation requirements, and learn more about the ACC tools available, the first PINNACLE Network webinar of 2012 focused entirely on PQRS. Got to http://www.cardiosource.org/webinars for the Jan. 26 archive of the PINNACLE Network PQRS webinar.
Last Year for Maximum Payment Under the EHR Incentive Program
This year marks the last year for physicians interested in participating in the Medicare Electronic Health Record (EHR) Incentive Program to receive the maximum payment. Physicians can earn up to $44,000 over five years if they meet the program requirements and begin participating in 2011 or 2012. First-year participants must only comply with the program’s requirements for 90 days. This means that participants in their first year have until Oct. 1 to comply. The Centers for Medicare and Medicaid Services (CMS) recently released a guide for beginners to the EHR Incentive Program and has produced measure specification sheets for all of the core and optional requirements, available at www.cms.gov/ehrincentiveprograms. The ACC has also partnered with the Managed Care Advisory Group (MCAG) to help members receive maximum incentive payments under the EHR Incentive Program. MCAG uses a dashboard to track physician progress in meeting the Meaningful Use requirements and help identify problem areas. Once requirements are met, MCAG will complete and send the application for the incentive bonus to CMS. More information on the EHR Incentive Program, ACC resources and MCAG, is available at CardioSource.org/HealthIT.
New Expert Consensus Document on TAVR Released
The American College of Cardiology Foundation (ACCF), in partnership with the American Association for Thoracic Surgery (AATS), Society for Cardiovascular Angiography and Interventions (SCAI), and the Society of Thoracic Surgeons (STS), recently released an Expert Consensus Document (ECD) on Transcatheter Aortic Valve Replacement (TAVR), a new technology for patients with severe aortic valvular stenosis who are either high-risk candidates or inoperable for surgical aortic valve replacement.
The document, which was co-published online on January 31 and will appear in the March 27 issue of the Journal of the American College of Cardiology, is intended to inform practitioners, payers and other interested parties of the opinions concerning how TAVR should be introduced into the practice community. The ECD also facilitates the integration of TAVR and enables responsible adaption and diffusion of the new technology. The authors note that “although the technique and equipment continue to evolve, TAVR is a complex procedure with many interlocking steps which require meticulous attention to achieve optimal results and minimize complications.” This past November the ACC and STS launched a STS/ACC TVT RegistryTM, a new benchmarking tool developed to track patient safety and real-world outcomes related to new and emerging transcatheter valve therapy (TVT) procedures.
For more information, visit CardioSource.org/TVT.
Legislative Practice Visits: Let Them See What the Cardiac Care Team Can Do
The ACC is urging members to join the advocacy effort by hosting a Legislator Practice Visit. These visits provide unique opportunities for federal and state government officials to witness first-hand how the cardiac care team provides patients with quality, cost-efficient care by employing state of the art technology, health care data and professional training through a team approach. These visits are also opportunities to establish and/or building upon personal relationships with policymakers at the state and/or federal level. Contact Elizabeth Ellis at firstname.lastname@example.org for more information or to set up a practice visit.
Countdown to ACC.12!
The ACC’s 61st Annual Scientific Session & Expo is fast approaching. Remember ACC.12 begins on Saturday, March 24, this year so plan accordingly when securing housing and booking flights. Attendees can also start planning ACC.12 activities using the ACC.12 Program Planner. In addition the ACC.12 Community is up and running and provides opportunities for ACC members to network with colleagues and stay on top late-breaking ACC.12 news before, during and after the meeting. You can also stay up to date on ACC.12 via the ACC’s Twitter (#ACC12) and Facebook pages.
Calling All FITs: Join the ‘FITs on the GO’ Community!
FITs, whether attending ACC.12 or not, can sign up now for the special “FITs on the GO” community, which is currently focused on ACC.12 activities and coverage specifically for FITs. To join the community and check out the latest videos and commentary, go to: http://www.CardioSource.org/FIT. In addition, FITs attending the meeting who are interested in serving as roving reporters should contact Amalea Hijar.
ACC Provides Industry Training Education
The ACC and the University of South Florida (USF) Department of Cardiovascular Sciences recently launched a novel program to provide comprehensive educational sessions designed to meet the needs of the health care industry. The first of these programs was focused on all aspects of diagnosis and management of atrial fibrillation, the second on acute coronary syndrome. Each of these programs featured two days of lectures, videos and interactive modules, encouraging group discussion of the material presented and a day of knowledge testing. The programs were led by Leslie Miller, MD, FACC, and Arthur Labovitz, MD, FACC, chairman and vice chairman of the USF Department of Cardiovascular Sciences, respectively. USF programs are now held in the new 90,000 square foot USF Center for Advanced Medical Learning and Simulation (CAMLS) in downtown Tampa, which offers simulation based education and training in a state of the art surgical center. Labovitz will also be leading an atrial fibrillation training course immediately preceding ACC.12 at the McCormick Center in Chicago. For more information, contact email@example.com or call 202-375-6182.
ACC International Hits Highest Rate of Growth
This past year the ACC saw an 18 percent increase in international members, the highest rate of growth the College has ever achieved in a 12-month period. ACC International membership is currently made up of over 5,200 members hailing from over 125 countries and 17 chapters. In addition, several new International chapters were launched around the globe, with Argentina, Chile, Venezuela and Singapore being the most recent additions. Learn more about the ACC’s growing international membership and chapters at http://www.CardioSource.org/International.
A Closer Look at 2012 Coding Changes
The 2012 Medicare Physician Fee Schedule final rule included several coding changes for 2012 in the field of cardiology. The most extensive changes in the field occur in two areas: renal angiography and pacemaker/implantable cardioverter-defibrillators. For more information on the coding changes, check out the January/February issue of Cardiology. In addition, the new CPT® Reference Guide for Cardiovascular Coding is available for purchase. For questions on specific coding issues, contact firstname.lastname@example.org. Also don’t miss the special session on coding at ACC.12.
Updated AUC for Coronary Revascularization
The ACC recently released the first focused update to its Appropriate Use Criteria (AUC) for Coronary Revascularization. The original criteria were published in 2009. The focused update takes into account new clinical trial results, as well as gaps noted during the last two years of implementation, to help ensure the most appropriate use of revascularization procedures. In particular, the updated criteria address two areas:
- Re-evaluation of the indications for the treatment of multivessel CAD with symptoms by PCI and CABG as a result of data from the SYNTAX trial, which came out after the original AUC were published; and
- Specific indications that represent gaps identified when mapping the 2009 AUC to the CathPCI Registry®.
ACC PAC Celebrates 10th Anniversary
To kick-off its 10th anniversary and better showcase news and events, the American College of Cardiology’s Political Action Committee (ACCPAC) has launched a new and improved website. Check out the site and learn more about ACCPAC activities across the country at www.accpacweb.org. In addition, stay tuned for exciting 10th anniversary celebrations at ACC.12.
ACC In Touch Blog: The Maryland Battle Continues
The topic of inappropriate use of stenting has been a hot topic this past year in several states including Maryland. In a recent ACC In Touch Blog post, ACC Board of Governors Chair Thad Waites discusses the diligent efforts by the Maryland Chapter to implement internal and external peer review, despite criticism and pushback from other groups, including fellow state chapters. Waites writes: “Although the battle in Maryland continues, their gallant efforts have not gone unnoticed, and this past week BOG Chair-Elect Dipti Itchhaporia and I presented Sam Goldberg, MD, FACC, governor of the Maryland Chapter with the ACC Chapter award for Advocacy.” Read the full blog post at blog.cardiosource.org.
ACC Investigating Allegations of Incorrect Bundling
The ACC is investigating complaints regarding numerous health plans incorrectly bundling the reimbursement for interpreting echoes into the inpatient E&M procedure codes based on claims management software developed by McKesson. The ACC with American Society of Echocardiography and American Medical Association have sent letters of opposition to McKesson and several health plans including Aetna, Blue Cross Blue Shield of Texas, and Horizon Blue Cross Blue Shield of New Jersey. McKesson and Aetna responded that they agree both services should be separately reimbursed when the services meet CPT® reporting standards. However, payers report that medical record reviews have routinely seen physicians bill both services without completing the documentation requirements, namely the separate written report for the echo interpretation. McKesson and Aetna have concluded that when the reporting standards are met, the use of a modifier -25 (significantly, separate identifiable E&M service) or a modifier -59 (distant procedural service) will be recognized. For the full reporting standards, consult the ACC/AMA CPT Reference Guide for Cardiovascular Coding. The ACC reminds members to fully and completely document services rendered in the patient’s charts for accurate claims submission.
United Healthcare Modifies Cardiology Notification Program
Following complaints from the ACC and numerous cardiovascular practives, United Healthcare has extended the timeframe to submit Retrospective Notification for the Cardiology Notification Program from 14 to 30 calendar days. Effective Nov. 1, 2011, diagnostic cardiac catheterizations and electrophysiology (EP) implant procedures performed on an emergent basis, or during the course of an inpatient stay, can be submitted within 30 calendar days of the date of service. The UHC Cardiology Notification Program requires ALL diagnostic cardiac catheterizations and EP implant procedures to be pre-notified regardless of setting. For emergent and hospital inpatient cases, notification must be sent with 30 calendar days of the date of service. The ACC continues to work with UHC to express our concerns with the administrative burden and clinical criteria. Feel free to contact ACC Advocacy at 800.253.4636 with feedback on this program.
Key Points to remember
The UHC Cardiology Notification Program currently only includes diagnostic cardiac catheterizations and EP implant procedures (pacemakers and ICDs). Notifications for cardiovascular imaging tests, such as nuclear cardiology, cardiac computed tomography, and cardiac magnetic resonance, are separate and listed under the UHC Radiology Notification Program.
For more program details, visit UHC Cardiology Notification Program website.