CMS Provides Two Updates for the Part B Therapy for 2015

MLN Matters article MM8985 – 2015 Annual Update to the Therapy Code List that updates the therapy code list for Calendar Year (CY) 2015 by adding two "Sometimes Therapy" codes, and deleting two current codes. The update to the therapy code list reflects those made in the CY 2015 Healthcare Common Procedure Coding System and Current Procedural Terminology, Fourth Edition (HCPCS/CPT-4). Make sure your billing staff are aware of these changes. Specifically, CR 8985 updates the code list by adding HCPCS Codes 97607 (Neg press wnd tx) and 97608 (Neg press wound tx >50 cm) to the "sometimes therapy" codes and deleting HCPCS Codes G0456 and G0457 from the 2015 therapy code list. Code 97608 replaces current code G0457 effective January 1, 2015 and 97607 replaces current code G0456 effective January 1, 2015. Per CMS policy, therapy codes must always be assigned a discipline-specific modifier (physical therapy, GO = occupational therapy, and GN = speech-language pathology (SLP) services).
MLN Matters article MM8970 – Therapy Cap Values for Calendar Year (CY) 2015 that indicates that the cap threshold will increase $20 in 2015 to $1,940 per year for physical therapy (PT) and speech-language pathology (SLP) services combined, and $1940 per year for occupational therapy (OT) services. An exceptions process […]

November 26th, 2014|Newsfront, Reimbursement Corner|

Governor Deal Appoints Two DCH Board Members

On November 24, Governor Nathan Deal appointed Roger Folsom and Russ Childers to the Board of Community Health to fill the vacancies on the Board.  See their bios below:
Roger L. Folsom is president and owner of Med1st. He is a past-chair and current board of trustees member of Fairview Park Hospital and past-chair and current vice-chair of the Dublin-Laurens Development Authority. He is a member of the board of directors of Farmers State Bank and the Georgia Chamber of Commerce. Folsom earned a bachelor’s degree in biology from Valdosta State University and completed his graduate studies at the University of Georgia. He resides in Dublin.
Russ Childers has been a life and health insurance agent for 42 years. He has served as president and legislative chair of the Georgia Association of Health Underwriters and was chosen in 2000 as the Health Underwriter of the Year in Georgia. In 2010, he served as president of the National Association of Health Underwriters. He is the recipient of the 2014 Harold R. Gordon Memorial Award. Childers earned a bachelor’s degree from Georgia State University. He resides in Dublin.
GHCA welcomes these gentlemen to the board and looks forward to working with them.

November 26th, 2014|News, Newsfront|

AHCA’s Response to Changes Coming to Five-Star

The following memorandum comes from Mark Parkinson, President & CEO for the American Health Care Association (AHCA). AHCA has been working diligently on helping its members (you all!) get prepared for the Five Star program through their Quality Initiative Program; and through the significant improvements toLTC Trend Tracker, (a free member benefit) that can give you great assistance in quality improvement activities. I know the memorandum is long, but it is very important that our nursing facility members understand both the changes that will be forthcoming and the action steps that you can take to help you get prepared for these changes.
As you know, six years ago CMS implemented the Five-Star program for our sector. It was a system that we did not ask for and had virtually no input in. Yet the impact of the program was painfully clear: It failed to recognize the complexities of our work as well as the differences between long stay and short stay, and it ignored the value of work it did not measure.
Yet, true to our nature, we adapted and pressed forward. We succeeded when many simply expected us to fall short. We took a flawed system, and persuaded CMS to make […]

November 26th, 2014|News, Newsfront|

December Education 2014

This December 2014, GHCA is offering the following education programs:
December 2 in Stockbridge
Keeping You Informed: HIPAA, Legislation, Electronic Charting, Disaster Recovery Click to Register>>
December 2 in Tifton and December 4 in Stockbridge
Integrating Process Tools into your QAPI Plan Tifton Click to Register>>
Integrating Process Tools into your QAPI Plan-Stockbridge Click to Register>>
December 3 in Stockbridge
Medicare 101 Click to Register>>
December 10 in Stockbridge
AHCA Bronze Quality Award Workshop Click to Register>>
December 11 in Stockbridge
AHCA Silver Quality Award Workshop Click to Register>>
December 16 in Stockbridge
Ethical Issues: Elder Sexuality, Intimacy, and End of Life Care in LTC Click to Register>>

November 26th, 2014|Assisted Living, Education Updates|

2015 GHCA Winter Convention and Trade Show

‘Tis the season to make your plans to attend the 2015 GHCA Winter Convention and Trade Show, January 20-23, 2015 at the Renaissance Waverly Hotel and Cobb Galleria Centre in Atlanta, Georgia. You will experience an impressive and entertaining agenda with amazing people who will deliver the tools to help you enjoy improved outcomes through the pursuit of happiness.  Register today to attend or exhibit and claim your spot at GHCA’s largest event of the year. You won’t want to miss this one!

Click HERE to Learn More and to Register for the 2015 GHCA Winter Convention

Click HERE To Register as an exhibitor

November 26th, 2014|Assisted Living, Convention, Education Updates, Sponsorship, Trade Show, Uncategorized|

Combine Leadership and Humor at NCAL’s Spring Conference

Looking for New Ways to Motivate Your Team With Humor?
Find out how to "unleash your inner tyrant" at the NCAL Spring Conference, March 9-11, 2015.
Opening keynote speaker Jeff Havens, a former standup comic who has appeared on variety of cable news outlets, will detail his book, Unleash Your Inner Tyrant!: Proven Strategies to Help You Become a More Horrible Boss . Jeff’s ability to help people achieve success in leadership, customer service, communication, generational issues, corporate culture and more by combining leadership skills with humor has helped him become an in-demand speaker across the country.
Open the door to other educational opportunities at NCAL’s assisted living focused conference, held in Fort Lauderdale, Florida. Register today for the chance to earn up to 10.5 CEUs and network with professionals from across the country. Sessions include customer satisfaction, workforce stability, dementia care, risk management, quality improvement, care transitions, and emergency preparedness.
Assisted living providers from across the country consider NCAL’s Spring Conference to be a must-attend event. Learn to thrive in a new health care environment by committing to your future by attending NCAL’s Spring Conference today!
By registering today you will save $125 off the on-site registration rate!
Also consider  registering for the AHCA/NCAL Independent Owner Leadership Conference, occurring […]

November 25th, 2014|Assisted Living, Newsfront|

CMS Releases “Medicare Appeals Process” Podcast

The CMS “Medicare Appeals Process” Podcast is now available. This 15 minute long MP3 audio podcast is designed to provide education on the five levels of claim appeals in Original Medicare (Medicare Part A and Part B). It includes details explaining how the Medicare appeals process applies to providers, participating physicians, and participating suppliers in addition to including more information on available appeals-related resources.

November 25th, 2014|Newsfront, Reimbursement Corner|

Modifier 59 Use – Outpatient Therapy Services

Recently there has been some confusion among providers of Part B therapy services regarding how to properly comply with the National Correct Coding Initiative (NCCI) edits.  In response to provider questions regarding whether these new modifier codes should be used for outpatient therapy services, CMS provided the following guidance to AHCA and other organizations to share with providers:
Re: CR 8863 & MM 8863 – Specific Modifiers for Distinct Procedural Services
CMS is establishing four new HCPCS modifiers to define subsets of the 59 modifier, a modifier used to define “Distinct Procedural Services”
The four new modifiers:

XE Separate Encounter, A Service That Is Distinct Because It Occurred During A Separate Encounter
XS Separate Structure, A Service That Is Distinct Because It Was Performed On A Separate Organ/Structure
XP Separate Practitioner, A Service That Is Distinct Because It Was Performed By A Different Practitioner
XU Unusual Non-Overlapping Service, The Use Of A Service That Is Distinct Because It Does Not Overlap Usual Components Of The Main Service 
At this time, the below statements represent CMS policy about the use of the new X{EPSU} modifiers for therapy services; and, is being sent in response to inquiries about their use on claims […]

November 25th, 2014|Newsfront, Reimbursement Corner|

October Revenues Up 5.9 Percent

Governor Nathan Deal announced earlier this month that Georgia’s net tax collections for October totaled $1.55 billion, an increase of $87 million, or 5.9 percent, compared to October 2013. Year-to-date, net tax revenue collections totaled $6.24 billion, which was an increase of $298.5 million, or 5 percent, compared to the previous fiscal year, when net tax revenues totaled $5.94 billion after four months. Year-to-date gross tax revenues, before refunds and distributions to local governments, totaled nearly $8.2 billion, which was an increase of $453.5 million, or 5.9 percent, compared to October 2013.

November 25th, 2014|Legislative, Newsfront|

General Election Outcome

Earlier this month, close to half of Georgia’s registered voters turned out to vote in the 2014 general election. Unlike most predictions, neither the race for Governor nor U.S. Senate will be heading to a runoff.  The Georgia Health Care Association looks forward to getting to know these newly elected officials as the legislative session draws near.  Results of key races can be found below, as well as links to the complete results.

Governor: Nathan Deal 52.8% v Jason Carter 44.8%
U.S. Senate: Perdue 52.9% v Michelle Nunn 45.2%
Lieutenant Governor: Casey Cagle 58% v Connie Stokes 42%
Secretary Of State: Brian Kemp 57.5% v Doreen Carter 42.5%
Attorney General: Samuel Olens 57% v Greg Hecht 43%

Statewide and Congressional Results, click HERE.
State Senate Results, click HERE.
State House of Representatives Results, click HERE.

November 25th, 2014|Legislative, Newsfront|