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CODING

Here’s how to represent telehealth encounters in QRDA I Format for eCQMs

The Centers for Medicare & Medicaid Services (CMS) has posted additional guidance for using the Quality Reporting Document Architecture I (QRDA I) format to represent telehealth encounters for the Eligible Professional and Eligible Clinician electronic clinical quality measures (eCQMs) used in CMS quality reporting programs for the 2020 and 2021 performance periods. There is no change to the original guidance provided by CMS in July 2020. Representing Telehealth Encounters in QRDA I format by using the Qualifier attribute: To represent “telehealth-eligible” Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes for eCQMs in QRDA I, submitters should use the optional qualifier attribute of the encounter code element to send the telehealth modifier code in addition to the primary “telehealth-eligible” CPT or HCPCS encounter code from the eCQM-specified value sets. The qualifier attribute name is… . . . read more.

COMPLIANCE

What, if anything, does OSHA require you to do to protect telecommuters?

While telecommuting is nothing new, the imperative for using it has never been greater. In addition to all the cost-saving, work-life balance, recruiting and hiring advantages, letting employees work from home during a pandemic has become a vital infection control measure. But it also poses significant compliance challenges, particularly in the realm of OSHA. After all, how are you supposed to meet your duty to protect the health and safety of employees if they work from home at a location beyond your physical control? This article will provide the answer. Spoiler alert: OSHA requirements don’t generally extend to employees working from home; but you still can and should take some basic steps to ensure their health and safety. OSHA & telecommuters The Occupational Safety and Health Act (Section 4(a)) applies… . . . read more.

COMPLIANCE QUIZ

Can racial discrimination be proven with circumstantial evidence alone?

SITUATION An equipment repair technician who also happens to be the office’s only African American employee endures racial abuse at the hands of his supervisor and co-workers. He complains to management and is warned to “stay in his lane.” Shortly thereafter, somebody leaves a noose on his desk. It’s the last straw. The technician claims he was subject to systemic racial discrimination and files an EEOC complaint. The office closes ranks and vehemently denies the charges and nobody is willing to testify on the technician’s behalf. Without witnesses to corroborate his story, the technician is left to rely on the following evidence: Pictures of the noose on his desk; His own testimony, which is credible and reliable; and The fact that the manager and supervisor’s denials lack credibility and consistency…. . . . read more.

QPP

Deadline Oct. 5 to ask for MIPS targeted review

If you participated in the Merit-based Incentive Payment System (MIPS) in 2019, your performance feedback, including your MIPS final score and payment adjustment factor(s), is now available for review on the Quality Payment Program website. This final score determines the payment adjustment you will receive in 2021, with a positive, negative, or neutral payment adjustment being applied to the Medicare paid amount for covered professional services furnished by a MIPS eligible clinician in 2021. MIPS eligible clinicians, groups, and virtual groups (along with their designated support staff or authorized third-party intermediary), including APM participants, may request the Centers for Medicare & Medicaid Services (CMS) to review the calculation of their 2020 MIPS payment adjustment factor(s) through a process called targeted review. The deadline to submit your request is Oct. 5, 8 p.m…. . . . read more.

Tool: Model Mandatory Face Mask Policy

More than 20 states have enacted laws requiring the use of face masks or coverings in indoor public places, which would include workplaces like medical offices. Here’s a Model Policy incorporating current legal requirements and public health guidance that you can adapt for your own office.

QPP

2019 MIPS performance feedback and final score available now

The Centers for Medicare & Medicare Services (CMS) has released 2019 Merit-based Incentive Payment System (MIPS) performance feedback and final scores. If you submitted data for the 2019 performance period, you can view your MIPS performance feedback and final score on the Quality Payment Program website. You can access your 2019 MIPS performance feedback and final score by: Going to cms.gov/login Logging in using your HCQIS Access Roles and Profile (HARP) system credentials; these are the same credentials that allowed you to submit your 2019 MIPS data If you don’t have a HARP account, please refer to the Register for a HARP Account document in the QPP Access User Guide and start the process now. To learn more about performance feedback, review the 2019 MIPS Performance Feedback Resources: 2019 MIPS Performance Feedback FAQs—Highlights what performance… . . . read more.

COMPLIANCE

How to create and implement a mandatory face mask policy at your medical office  

What began as a CDC guideline is evolving into a legal duty with more than 20 states and countless municipalities across the country adopting laws requiring individuals to wear masks or face coverings in enclosed indoor public spaces, including medical offices. As a result, medical offices must adopt and enforce mandatory mask policies at their facilities. While mask requirements vary slightly by jurisdiction, here are the 10 basic elements they should include. Defining our terms  This analysis is about non-medical face masks that people at medium at low risk levels are required to wear, as opposed to N95 particulate respirators and more elaborate respiratory equipment, eye and face shields other personal protection equipment (PPE) required for personnel at high risk of infection. Policy statement Start by stating that office entrants… . . . read more.

REIMBURSEMENT

Your office will be paid for counselling patients to self-isolate at time of COVID-19 testing

CMS and the Centers for Disease Control and Prevention (CDC) have announced that payment is available to physicians and health care providers to counsel patients at the time of COVID-19 testing about the importance of self-isolation after they are tested and prior to the onset of symptoms. The transmission of COVID-19 occurs from both symptomatic, pre-symptomatic, and asymptomatic individuals. Education on self-isolation is important as the spread of the virus can be reduced significantly by having patients isolated earlier while waiting for test results or symptom onset. The CDC models show that when individuals who are tested for the virus are separated from others and placed in quarantine there can be up to an 86 percent reduction in the transmission of the virus, compared to a 40 percent decrease in… . . . read more.

CMS

Resource ready for next year’s QRDA Implementation

The Centers for Medicare & Medicaid Services (CMS) has published the Quality Reporting Document Architecture (QRDA) Category III Implementation Guide (IG), Schematron, and Sample Files for Eligible Clinicians and Eligible Professionals Programs. The 2021 CMS QRDA III IG outlines requirements for eligible clinicians and eligible professionals to report electronic clinical quality measures (eCQMs), improvement activities (IA), and promoting interoperability (PI) measures for the calendar year 2021 performance period for these programs: · Quality Payment Program: Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs) · Comprehensive Primary Care Plus (CPC+) · Primary Care First (PCF) · Medicaid Promoting Interoperability (PI) The 2021 CMS QRDA III IG contains these high-level changes as compared with the 2020 CMS QRDA III IG: · Clarification of CPC+ QRDA III requirements in section 4.1 · Preliminary QRDA… . . . read more.

WORKPLACE SAFETY

Use contact logging to ensure medical office employees practice social distancing

Managing a medical office compliance program in the age of COVID-19 poses new and unprecedented challenges. One of the biggest and most important is ensuring that employees and the persons they interact with on the job follow social distancing requirements. To succeed in this effort, you must have the capability to track actual encounters. One possibility is digital technology, the use of apps, wearables and other so called “contact tracing” solutions that monitor encounters in real time. But in addition to being highly privacy-invasive, these solutions may be too costly and cumbersome for many offices. So, you may want to consider using this cheaper, easier and less intrusive manual method instead. What’s at stake Without a vaccine or treatment, social distancing, i.e., keeping at least six feet away from other… . . . read more.


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