Oncology & Hematology Coding Alert

Question: I heard that physicians may receive bonuses for e-prescribing. What codes would we report for this program?

Florida Subscriber

Answer: Physicians who adopt e-prescription systems are eligible to earn a bonus of 2 percent of their total Medicare allowed charges. The physician does not have to register to be considered for the 2 percent bonus from eprescribing. The physician must report e-prescription activity on 50 percent of the Medicare patients he sees.

Reporting includes three G codes, which indicate one of three conditions:

- G8443 -- All prescriptions created during the encounter were generated using a qualified e-prescribing system

- G8445 -- No prescriptions were generated during the encounter, provider does have access to a qualified e-prescribing system

- G8446 -- Provider does have access to a qualified e-prescribing system and some or all prescriptions generated during the encounter were printed or phoned in as required by state or federal law or regulations, patient request, or pharmacy system being unable to receive electronic transmission; or because they were for narcotics or other controlled substances.

Medicare is offering the bonus because -E-prescribing can greatly reduce the number of medication errors that jeopardize the health and safety of Medicare patients and waste precious health care dollars treating conditions that never should have happened,- according to CMS Acting Administrator Kerry Weems.

Bumps in the road: Some physicians have noted problems with e-prescribing including:

- not all pharmacies have the ability to capture eprescriptions

- laws may prevent the provider from e-prescribing narcotic medications

- the provider may not be able to e-prescribe across state lines for patients who live out-of-state.

You can find more information online at www.cms.hhs.gov/PQRI/Downloads/E-PrescribingMeasureSpecifications.pdf.