ideaman911 wrote on Thursday, May 28, 2009:
Folks;
If you are using an e-prescribing system like e-Scripts (which is free) or others while you use OpenEMR, you are still able to claim the 2% incentive from Medicare. The following is the note I wrote to a client (Lynne) and her Biller (Ruby) on HOW:
Per the CMS instructions for handling Medicare claims to receive the incentive payments for 2009, you must report one of three specific G codes as a CPT along with the specific CPT service code(s) and ICD justify diagnoses in the Fee Sheet for any Medicare encounter. Based on what we have seen, it probably is good to add the codes for EVERY encounter, until we are told by insurers specifically not to. Those who do not report them to CMS will simply reject them with a "Not Covered Service".
The rules stipulate that a near-zero dollar amount MUST be shown (we will show $0.01, the lowest which will display in OpenEMR) for each encounter. They will show according to CMS on EOB’s as rejected, but will have an N365 remark, which is a “data collect code”, and by that code we will know that they have been registered by CMS as part of our calculated submittals.
To allow that process, I used the Superbill to add the three codes as CPT4 codes with Fee of $.01, then entered a new drop-down group called e-Prescribing in the Admin - Lists - Fee Sheet showing each of the codes and their description, making note of their distinctions (which I show below).
To assure the maximum potential, you will want to re-submit via X12 as soon as you have the portal active for Medicare billing, ALL 2009 Medicare bills INCLUDING previously submitted where we did NOT have those codes shown (note - these could alternatively be submitted on CMS 1500 forms). They will reject for duplicate submittal, but will NOW register the N365 as well. But since Medicare is currently the ONLY one with specific incentive payments, no others need be retroactively re-processed.
Lynne; that will require you to select from the e-Prescribing drop-down now in Fee Sheet. The choices are G8443 when ALL Rx for an encounter were e-prescribed, G8445 for e-Rx was available but NO Rx were needed, or G8446 for e-Rx was available but you were prevented from using it for SOME Rx. Examples will be for DEA and state limits on e-Rx for controlled substances, pharmacies who cannot accept e-Rx or if the patient specifically requests a printed or phoned-in Rx.
Ruby; in order for Lynne to add those codes to already billed encounters, they must be "re-opened" in the Billing module. Probably the simplest way to do that will be to select all encounter dates from 1/1/09, uncheck "unbilled only" and update the listing, and then look at the Primary Insurer field and select all which have Medicare B and show a "Billed" date in their listing, then "re-open" all selected. You and Lynne can then determine who can best enter those codes in the Fee Sheet for each, since Lynne will have indicated where and what she did with prescribing.
Note that there is NO NEED to do any justify on these codes, and that they are all found in the new "e-Prescribing" drop-down in Fee Sheet. I have verified that all print correctly in both CMS 1500 and X12 versions from OpenEMR Billing in 3.0.1 version.
Joe Holzer Idea Man
http://www.holzerent.com