arkansas medical societya legal document. the official medicare program provisions are contained in...
TRANSCRIPT
9/18/2015
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Proprietary and Confidential
Arkansas Medical Society
Novitas Solutions
Jurisdiction H
October 2015
Disclaimer
• All Current Procedural Terminology (CPT) only are copyright 2014 American Medical Association (AMA). All rights reserved. CPT is a registered trademark of the American Medical Association. Applicable Federal Acquisition Regulation/ Defense Federal Acquisition Regulation (FARS/DFARS) Restrictions Apply to Government Use. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
• The inf ormation enclosed was current at the time it was presented. Medicare policy changes frequently;
links to the source documents have been provided within the document for your reference. This presentation was prepared as a tool to assist providers and is not intended to grant rights or impose obligations.
• Although ev ery reasonable effort has been made to assure the accuracy of the information within these pages, the ultimate responsibility for the correct submission of claims and response to any remittance adv ice lies with the provider of services.
• Nov itas Solutions employees, agents, and staff make no representation, warranty, or guarantee that this
compilation of Medicare information is error-free and will bear no responsibility or liability for the results or consequences of the use of this guide.
• This presentation is a general summary that explains certain aspects of the Medicare program, but is not a legal document. The official Medicare Program provisions are contained in the relevant laws, regulations, and rulings.
• Nov itas Solutions does not permit videotaping or audio recording of training events.
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Novitas Solutions
• Education specific to providers in Medicare Administrative Contractor Jurisdiction H (JH) include: Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, and Texas
• Education specific to providers in Medicare Administrative
Contractor (MAC) Jurisdiction L (JL) include: Delaware, District of Columbia, Maryland, New Jersey, and Pennsylvania
• This education contains specific contractor guidance
• If you are not a provider in JL or JH, please contact your Medicare contractor for specific guidance
Agenda
• Novitas Initiatives
• Medicare Updates
• Compliance
• Website Features and Resources
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Objectives
• Identify and understand the current
Medicare changes
• Learn how to apply the new guidelines
• Identify and utilize the educational
resources and information
Acronym List
Acronym Definition
CMS Centers of Medicare & Medicaid Services
EDI Electronic Data Interchange
LCD Local Coverage Determination
MLN Medicare Learning Network
NPI National Provider Identifier
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Novitas Initiatives
Website Improvements
• Based on your feedback we continue to
improve our website
• Recent website improvements
o Content pages now include ‘Last Updated’ date
o Continued cleanup of outdated documents
o Quick access rolling banner spotlighting Medicare news
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What is Novitasphere?
• Novitasphere is our free web-based Portal that will allow providers access to Eligibility, Claim Information and Remittance Advice, Claim Submission with File Status, Electronic Remittance Advice (ERA), Claim Correction, and MailBox
• Novitasphere is available to the Jurisdiction H and Jurisdiction L Part B Provider Community
• Visit the Learning Management System to Register for all of demonstrations being offered for Novitasphere
• More Information on Novitasphere can be located on our website www.novitas-solutions.com or by accessing the links below o http://www.novitas-
solutions.com/webcenter/spaces/MedicareJH/page/pagebyid?contentId=00081055
• Novitasphere is now available for Billing Services and Clearinghouses that service Part B practitioners! o Stay tuned f or EDI Mailing List Messages regarding testing and enrollment
Novitasphere Registration
• Step 1: Determine who the Provider Office Approver, or primary person from your office, who will be responsible for accessing the application
• Step 2: Complete the Electronic Data Interchange (EDI)
Portal Enrollment form (8292P/8292PJH) found in the Enrollment section of the Novitasphere Center of our website o Fax the completed form to 1-877-439-5479
• Step 3: Once the EDI enrollment form is approved, you will
receive instructions to apply for a User ID for the Provider Office Approver, and the required next steps to set up access for your organization and End Users
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Novitasphere Claim
Correction Feature
• Save your office valuable time with this great Novitasphere feature!
• It’s free, quick, easy, and secure to do on-line with no need to call our Claim Correction line!
• The following common clerical errors can be corrected on finalized claims through the Novitasphere Claim Correction feature o Number of services or units o Diagnosis code (Primary)
o Eligible modifiers o Procedure code
o Date of service o Place of service o Billed amount
• Novitasphere Claims Correction Guide o http://novitas-
solutions.com/cs/idcplg?IdcService=GET_FILE&RevisionSelectionMethod=LatestReleased&dDocName=00086496&allowInterrupt=1
Novitasphere Help Desk
1-855-880-8424
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Increasing Your Bottom Line:
How Much Does Rework Cost Your
Organization?
• Campaign began May 2015
• Focus on cost savings for providers by reducing the need for reopening requests
• Website page dedicated to the campaign o http://www.novitas-
solutions.com/webcenter/portal/MedicareJH/pagebyid?contentId=00092539
• Long term initiative with new articles added frequently
• Periodic webinars are being conducted
Increasing Your Bottom
Line: Education Initiatives
• Adding/changing modifiers is the largest reason for reopening requests, articles published so far o Mod 59 – Unlikely pairing of codes
o Mod 76 – Repeat Procedure, same Physician
o Mod 77 – Repeat Procedure, different Providers
o Mod KX – Attestation for Therapy Services
o Mod 26 and TC – Professional and Technical Component
• http://www.novitas-solutions.com/webcenter/portal/MedicareJH/pagebyid?contentId=00092539
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Policy Search Application
• Updated customized “Policy Search Application” August 14, 2015
• Search o Current, retired or draft policies
o ICD-9 LCDs and Articles o ICD-10 LCDs and Articles
o National Coverage Determinations (NCDs)
• Gives more search power, more accurate results, the new options allows for search by date of service
• Policy Search o http://www.novitas-
solutions.com/webcenter/spaces/MedicareJH/page/LcdSearch
Novitas Medicare
Learning Center
• Features o Create an individualized education account
o Register for webinars, teleconferences, and workshops
o Download your Continuing Education Unit (CEU) Certificates
o Be placed on a waitlist if the educational event you register for is closed
• Benefits o Centralized location for all educational materials
o Track all of the educational events you’ve attended
o Access Medicare education 24 hours a day, 7 days a week with web-based training modules
• http://www.novitas-solutions.com/webcenter/spaces/MedicareJH/page/pagebyid?contentId=00081812
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Medicare Updates
Updates to ICD-10 Local Coverage
Determinations
• Special Edition Article SE1421
• Key Points
o Advises how to access ICD-10 Local Coverage
Determinations (LCDs) in the CMS Medicare Coverage Database (MCD)
• Reference
o http://www.cms.gov/Outreach-and-Education/Medicare-
Learning-Network-
MLN/MLNMattersArticles/Downloads/SE1421.pdf
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CMS and AMA Help Providers Get
Ready for ICD-10
• No medical review denials the f irst year related to coding errors as long as the
code is in the “appropriate family” of ICD-10 codes
o Applicable for services paid under the Medicare Fee-for-Service Part B
physician fee schedule
• Codes must be valid, carried out to the highest level of specif icity
• Reduced fear regarding, revenue losses associated w ith coding error denials
• Maintain emphasis on coding productivity
• References
o http://w w w.cms.gov/New sroom/MediaReleaseDatabase/Press-
releases/2015-Press-releases-items/2015-07-06.html
o http://w w w.cms.gov/Medicare/Coding/ICD10/Dow nloads/ICD-10-
guidance.pdf
o https://w w w.cms.gov/Medicare/Coding/ICD10/Clarifying-Questions-and-
Answ ers-Related-to-the-July-6-2015-CMS-A MA-Joint-Announcement.pdf
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New CMS ICD-10 Communication
and Collaboration Center
• Communications sent to providers
o Encouraging ICD-10 readiness and flexibility
• Providing additional in-person training
through the “Road to 10” for small
physician practices.
• Established Ombudsman for physicians
and other providers
• No penalties on 2015 quality reports
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More Resources for ICD-10
• Novitas Website o http://www.novitas-
solutions.com/webcenter/spaces/MedicareJH/page/pagebyid?contentId=00027400
• Information and Resources for Submitting Correct ICD-10 Codes to Medicare o http://www.cms.gov/Outreach-and-Education/Medicare-Learning-
Network-MLN/MLNMattersArticles/Downloads/SE1518.pdf
• CMS and AMA Announce Efforts to Help Providers Get Ready For ICD-10 o http://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-
releases/2015-Press-releases-items/2015-07-06.html# o FAQs
https://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD-10-guidance.pdf
Update to Publication 100-04
Chapter 18
• Change Request # CR 8628 o Effective: January 1, 2012
o Implementation: September 15, 2015; upon implementation of ICD-10
• Key Points o Updates were made to the 2/12 version of the Form CMS-
1500 and ASC X12 and Contractor types o Suggested ICD-10 diagnosis codes were added to various
preventive service benefits
• Reference o http://collaborate.novitas-
solutions.com/novitas/poedu/Lists/2013%20CR%20Tracking/Attachments/939/CR8628.pdf
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Reporting the Service Location National
Provider Identifier (NPI) on Anti-Markup
and Reference Laboratory Claims
• Change Request # 8806 o Effective: October 1, 2015
o Implementation: October 5, 2015
• Key Points o Item 32a (or electronic equivalent) must contain the NPI of
the physician or supplier who actually performed the service
o Applies to all claims
• Reference o http://www.cms.gov/Outreach-and-Education/Medicare-
Learning-Network-MLN/MLNMattersArticles/Downloads/MM8806.pdf
New and Revised Place of Service
Codes (POS) for Outpatient
Hospitals
• Change Request # 9231 o Effective: January 1, 2016
o Implementation: January 4, 2016
• Key Points o POS 19 Off Campus-Outpatient Hospital
o POS 22 On Campus-Outpatient Hospital
o POS 17 Walk-in Retail Health Clinic o POS 26 Military Treatment Facility
• Reference o https://www.cms.gov/Outreach-and-Education/Medicare-
Learning-Network-MLN/MLNMattersArticles/Downloads/MM9231.pdf
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Remittance Advice Remark and Claims
Adjustment Reason Code and Medicare
Remit Easy Print and PC Print Update
• Change Request # 9278 o Effective: October 1, 2015
o Implementation: October 6, 2015
• Key Points o Recurring update to the CARC and RARC lists
o Instructions to update MREP and PC Print
• Reference o https://www.cms.gov/Outreach-and-
Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM9278.pdf
Claims Processing Instructions for
Diagnostic Digital Breast Tomosynthesis
• Change Request # 9191 o Effective: January 1, 2015
o Implementation: January 4, 2016
• Key Points o Payment for code G0279 will be permitted only when billed in conjunction with codes
G0204 or G0206
o Deductible and coinsurance will be applied to claim lines with code G0279
o Institutional claims for code G0279 will be paid for type of bills 12X, 13X, 22X, 23X, and 85X when submitted with revenue code 0401
o Professional claims for code G0279 will be paid for TOB 85X when submitted with revenue code 096X, 097X, or 098X
o Contractors will pay for code G0279 on institutional claims TOBs 12X, 13X, 22X, and 23X based on the Medicare Physician Fee Schedule and TOB 85X with revenue code other than 096X, 097X, and 098X based on reasonable cost
o Contractors will pay code G0279 on claims with TOB 85X with revenue code 096X, 097X, or 098X based on MPFS
• Reference o https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-
MLN/MLNMattersArticles/Downloads/MM9191.pdf
Current Procedural Terminology (CPT) only copyright 2014 American Medical Association. All rights reserved.
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End Stage Renal Disease
(ESRD) Home Dialysis Policy
• Change Request # CR 9265 o Effective: January 1, 2015
o Implementation: September 8, 2015
• Key Points o Physician and nonphysicians need to bill Monthly Capitation
Payments (MCP) for the age appropriate home dialysis MCP service for the home dialysis scenario if the MCP practitioner furnishes
o Complete monthly assessment of the ESRD beneficiary; and
o At least one face-to-face patient visit during the month
• Reference o https://www.cms.gov/Outreach-and-Education/Medicare-
Learning-Network-MLN/MLNMattersArticles/Downloads/MM9265.pdf
National Site Visit (NSV)
Verification Initiative
• Special Edition Article SE1520
• Key Points o NSVC will conduct unannounced site visits
Observational site visit or
Detailed review
o Verify site visit http://www.cms.gov/Medicare/Provider-Enrollment-and-
Certification/MedicareProviderSupEnroll/Downloads/contact_list.pdf
– This link also provides a list of entities that require a site visit
• Reference o https://www.cms.gov/Outreach-and-Education/Medicare-
Learning-Network-MLN/MLNMattersArticles/Downloads/SE1520.pdf
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Limiting the Scope of Review on
Redeterminations and Reconsiderations
of Certain Claims
• Special Edition Article SE1521
• Key Points o Claims denied following a post-payment review or audit
Instructed to limit our review to the reason the claim or line item was initially denied
o Denied on a pre-payment basis Continue to develop new issues and evidence May issue unfavorable decisions other than those specified in
the initial determination Requests received on or after August 1, 2015
• Reference o https://www.cms.gov/Outreach-and-Education/Medicare-
Learning-Network-MLN/MLNMattersArticles/Downloads/SE1521.pdf
Updates on the Therapy Cap
• Exceptions to the therapy cap will remain in effect for
claims with dates of service though December 31, 2017
• Hospital outpatient therapy claims will continue to apply
to the therapy cap though December 31, 2017
• Suspension for therapy services that exceed $3,700 will
remain in effect for therapy services though December
31, 2017
• https://www.cms.gov/Medicare/Billing/TherapyServices/i
ndex.html?redirect=/TherapyServices
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Physician Feedback, Quality and Resource
Use Reports (QRURs) and Value-Based
Modifier Program
• Special Edition Article SE1507 • Key Points
o The Value Modifier program is being gradually phased in. The payment adjustments will apply as follows In 2015 - to physicians in groups of 100 or more Eligible Professionals
(EPs), based on a 2013 performance period
In 2016 - to physicians in groups of 10 or more EPs based on 2014 performance;
In 2017 - to physician solo practitioners and physicians in groups of 2 or more EPs based on 2015 performance; and
Beginning 2018 - w ill also apply to non-physician EPs w ho are solo practitioners or are in groups of 2 or more EPs
• Reference o http://www.cms.gov/Outreach-and-Education/Medicare-Learning-
Network-MLN/MLNMattersArticles/Downloads/SE1507.pdf
New Waived Tests
• Change Request # 9261 o Effective: October 1, 2015
o Implementation: October 5, 2015
• Key Points o List of tests approved by the FDA as waived tests under CLIA
Test must include the QW modif ier
o One new CPT code 87651QW has been assigned for the Streptococcus group A test
o List of tests that do not require a QW modifier to be recognized as a waived
• Reference o https://www.cms.gov/Outreach-and-Education/Medicare-
Learning-Network-MLN/MLNMattersArticles/Downloads/MM9261.pdf
Current Procedural Terminology (CPT) only copyright 2014 American Medical Association. All rights reserved.
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Quarterly Update of HCPCS Codes
Used for Home Health
Consolidated Billing Enforcement
• Change Request # 9192 o Effective: October 1, 2015
o Implementation: October 5, 2015
• Key Points o Added code A7048 and deleted code A7043
o Added codes 97607 and 97608 and deleted code G0456 and G0457
• Reference o http://www.cms.gov/Outreach-and-
Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM9192.pdf
Current Procedural Terminology (CPT) only copyright 2014 American Medical Association. All rights reserved.
Quarterly Healthcare Common
Procedure Coding System (HCPCS)
Drug/Biological Code Changes
• Change Request # 9273
o Effective: October 1, 2015
o Implementation: October 5, 2015
• Key Points
o New HCPCS Code Q9979 for Injection, Alemtuzumab, 1MG
• Reference o https://www.cms.gov/Outreach-and-
Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM9273.pdf
Current Procedural Terminology (CPT) only copyright 2014 American Medical Association. All rights reserved.
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Compliance
Arkansas Top Claim
Errors
• Non-covered charge(s)
• Provider was not covered by Medicare
when you received this service
• Duplicate claim/service
• Claim not covered by this payer/contractor
• http://www.novitas-
solutions.com/webcenter/spaces/Medicare
JH/page/pagebyid?contentId=00003643
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Comprehensive Error
Rate Testing (CERT)
• What is it? A program developed CMS to randomly audit claims monthly to determine if they processed correctly
• Why does it matter? To protect the Medicare trust fund and determine error rates nationally and regionally
• Who is involved? You. A request for medical records from AdvanceMed alerts you that one of your claims has been selected as part of the monthly random sample
• How does it work? A letter will be sent to your office requesting the medical documentation. You need to comply in a timely manner with the request
• Novitas CERT Center o http://www.novitas-solutions.com/webcenter/spaces/CERT_JH
JH Part B Common Errors
• Insufficient documentation
o Missing or illegible documentation and/or physician signature
o Procedure/laboratory service billed
o No valid physician’s order
• Incorrect coding errors
o Evaluation and Management (E/M) codes
o Units of medication
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Recovery Audit (RA)
Program
• Identify and correct Medicare improper payments through the detection and collection of overpayments
• CMS webpage o https://www.cms.gov/Research-Statistics-Data-and-
Systems/Monitoring-Programs/Medicare-FFS-Compliance-Programs/Recovery-Audit-Program/
• Connolly Healthcare o 1-866-360-2507
o http://www.connolly.com/healthcare/Pages/CMSRACProgram.aspx
Office Inspector General
(OIG)
• OIG Work Plan outlines their current focus areas and states the primary objectives of each project
• Specific Items Include o Ambulance services
o Anesthesia services o Chiropractor
o Diagnostic radiology
o Place of Service o Physical therapists
• http://oig.hhs.gov/reports-and-publications/archives/workplan/2015/PartI-MedicarePartA-B-WPUpdate2015.pdf
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CMS Provider
Compliance Website
• Provider Compliance Products
o http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/ProvCmpl_Products.pdf
o Quarterly Provider Compliance Newsletter Volume 5, Issue 4, Dated July 2015
– http://cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Dow nloads/MedQtrlyComp-New sletter-ICN909220.pdf
o Provider Compliance Tips for Computed Tomography (CT Scans) https://www.cms.gov/Outreach-and-Education/Medicare-
Learning-Network-MLN/MLNProducts/MLN-Publications-Items/ICN907793.html
Stay Compliant
• Conduct internal monitoring and auditing
• Implement compliance and practice standards
• Designate a compliance officer or contact person
• Conduct appropriate training and education
• Respond appropriately to detected offenses and develop corrective actions
• Develop open lines of communication with employees
• Enforce disciplinary standards through well-publicized guidelines
• Accurate coding and billing
• Maintain accurate and complete medical documentation
• Stay current with Medicare rules and regulations
• Respond promptly and completely to Medicare inquiries
• Use good business sense
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Website Features and Resources
Novitas Home Page
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Novitas Solutions Home
Page
JH Local Coverage
Determinations (LCDs)
September 11, 2015
• The following JH Local Coverage Determinations (LCDs) have been revised
o Biomarkers Overview (L33638)
o Intraoperative Neurophysiological Testing (L32605)
o Outpatient Sleep Studies (L32711)
o Services That Are Not Reasonable and Necessary (L31686)
o Treatment of Varicose Veins and Venous Stasis Disease of the Lower Extremities (L32678)
• The following JH Local Coverage Article has been revised o Approved Drugs and Biologicals Includes Cancer
Chemotherapeutic Agents (A52018)
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Revised JH LCDs and
Articles
• Effective o Surgical Treatment of Nails (A47803)
• Revised o Application of Bioengineered Skin Substitutes to Lower Extremity
Chronic Non-Healing Wounds (A54115)
o Compounded Drugs Used in an Implantable Infusion Pump (A54099)
o Independent Diagnostic Testing Facility (IDTF) (A53186)
• Revised and will become effective October 1, 2015 o Self-Administered Drug Exclusion List (A53127)
• Added and will be effective October 1, 2015 o Ambulance Services (Ground Ambulance) (A54574)
• http://www.novitas-solutions.com/webcenter/portal/MedicareJH/pagebyid?contentId=00006151
Jurisdiction H Customer
Contact Information • Provider
o 1-855-252-8782
o Hours of Operation, Central Time (CT)/Mountain Time (MT) Monday - Friday: 8:00 am – 4:00 pm CT/MT
• Interactive Voice Response (IVR) o Hours of Operation
Eligibility and General Information – 24 Hours a day 7 Days a week
Full IVR Options – Mondays: 5:00 am – 7:00 pm CT
– Tuesday – Friday: 3:00 am – 7:00 pm CT – Saturdays: 5:00 am – 3:00 pm CT
o Step-by-Step Guide JH Part A
– http://www.novitas-solutions.com/webcenter/spaces/MedicareJH/page/pagebyid?contentId=00004409
JH Part B – http://www.novitas-solutions.com/webcenter/spaces/MedicareJH/page/pagebyid?contentId=00004421
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Beneficiary Contact
Information
• Patient / Medicare Beneficiary
o 1-800-MEDICARE (1-800-633-4227)
http://www.medicare.gov/index.html
Using Internet-based
PECOS is Easy!
• Advantages of Internet- based Provider Enrollment Chain and Ownership System (PECOS) o Completely paperless process
o Electronic signature and digital document features available o Processed faster than paper-based enrollment o Tailored process – you supply only the information relevant to your
application o More control over your enrollment information, including reassignments
o Easy to check status and update your information o Less time and cost to submit applications to Medicare
• Provider Enrollment Status Inquiry Tool o http://www.novitas-
solutions.com/webcenter/spaces/MedicareJH/page/pagebyid?contentId=00004864
• Upcoming Revalidation Mailings o http://www.cms.gov/Medicare/Provider-Enrollment-and-
Certification/MedicareProviderSupEnroll/Revalidations.html
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Stay Up-to-Date
• Electronic Mailing List o Daily E-mail of the latest Medicare Updates
o Newly designed and streamlined newsletter format
o Subscribe JH http://w w w.novitas-
solutions.com/w ebcenter/spaces/MedicareJH/page/pagebyid?contentId=00007968
• Podcast o Podcast of the latest Medicare Updates and other informative
topics
o http://www.novitas-solutions.com/webcenter/spaces/MedicareJH/page/pagebyid?contentId=00025071
• Educational Videos and Tutorials o http://www.novitas-
solutions.com/webcenter/spaces/MedicareJH/page/pagebyid?contentId=00082787
Calendar of Events
• Our Education and Training Center offers a wide variety of education
• Join us for Workshops, Teleconferences, and Webinars
• The most current calendar of events
o JH Part A http://w w w.novitas-
solutions.com/w ebcenter/spaces/MedicareJH/page/pagebyid?contentId=00084381
o JH Part B http://w w w.novitas-
solutions.com/w ebcenter/spaces/MedicareJH/page/pagebyid?contentId=00084382
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Centers for Medicare &
Medicaid Services (CMS)
• The CMS website offers valuable
resources such as
o CMS Internet Only Manuals (IOMs)
o Medicare Learning Network (MLN) Matters Articles
o Open Door Forum
• http://www.cms.gov/
Medicare Learning Network (MLN)
Products for Preventive Services
• Help Keep Your Medicare Patients Healthy In 2014!
• Ensure your patients take advantage of Medicare-covered preventive services.
• Medicare covers a wide array of preventive services for eligible beneficiaries, including cancer screenings, certain immunizations, among others.
• The Medicare Learning Network (MLN) Preventive Services Educational Products Web Page provides descriptions and ordering information for MLN preventive services educational products and resources for health care professionals and their staff. o http://www.cms.gov/Outreach-and-Education/Medicare-Learning-
Network-MLN/MLNProducts/PreventiveServices.html
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Preventive Services and Screenings
Covered by Medicare
• Abdominal Aortic Aneury sm Screening
• Alcohol Misuse Screening and Behav ioral counseling Interv ention in Primary Care
• Annual Wellness Visit (Including Personalized Prev ention Plan Serv ices)
• Bone Mass Measurements
• Cancer Screenings
o Breast Cancer (mammograms and clinical breast exam)
o Cerv ical and Vaginal Cancer (pap test and pelv ic exam [includes the clinical breast exam])
o Colorectal Cancer
Fecal Occult Blood Test
Flexible Sigmoidoscopy
Colonoscopy
Barium Enema
o Prostate (Prostate Specif ic Antigen blood test and Digital Rectal Exam)
• Cardiov ascular Disease Screening
• Depression Screening in Adults
• Diabetes Screening
• Diabetes Self -Management Training
• Glaucoma Screening
• Human Immunodef iciency Virus (HIV) Screening
• Immunizations (Seasonal Inf luenza, Pneumococcal, and Hepatitis B)
• Initial Prev entiv e Phy sical Examination (IPPE) (also commonly ref erred to as the “Welcome to Medicare” Prev entiv e Visit)
• Intensiv e Behav ioral Therapy f or Cardiov ascular Disease
• Intensiv e Behav ioral Therapy f or Obesity
• Medical Nutrition Therapy (f or benef iciaries with diabetes or renal disease)
• Sexually Transmitted Inf ections (STIs) Screening and High-Intensity Behav ioral Counseling (HIBC) to prev ent STIs
• Tobacco-Use Cessation Counseling
Preventive Services
• Quick Reference Chart for Medicare Preventive Services o https://www.cms.gov/Medicare/Prevention/PrevntionG
enInfo/Downloads/MPS_QuickReferenceChart_1.pdf
• Improve Your Patients’ Health with the Initial Preventive Physical Examination (IPPE) and Annual Wellness Visit (AWV)
o http://collaborate.novitas-solutions.com/novitas/poedu/Lists/2013%20CR%20Tracking/Attachments/279/SE1338.pdf
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JH Contacts
Denise Church
Manager Provider Outreach and Education
412-802-1739
Greg Hart
Supervisor Provider Outreach and Education
501-690-2931
Questions
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30
Thank you for your
participation!