Primary Care Coding Alert

News and Notes:

Don't Miss the Latest Updates on Incentive Payment Program and ICD-10 Help

Plus: Rural health providers, check your listing for accuracy.

If you have a physician or other provider involved in the Primary Care Incentive Payment program (PCIP), your bottom line will see an increase in 2012. Family practice and internal medicine specialists will benefit from a 1 percent gain this year over the RVU amounts they received for participation in 2011.

What it is: The PCIP is an incentive payment of 10 percent of Medicare's program payments to be paid to primary care physicians and non-physician practitioners for services rendered from Jan. 1, 2011 until Dec. 31, 2015. Eligible services fall under CPT® codes:

  • 99201-99215 for office and other outpatient visits
  • 99304-99340 for nursing facility, domiciliary, rest home, or custodial care
  • 99341-99350 for home services.

Get the latest details from CMS online by visiting http://questions.CMS.hhs.gov and searching for "PCIP" or "Primary Care Incentive Payment."

Download Your ICD-10 Templates From CMS

Although the ICD-10 implementation date will be later than Oct. 1, 2013, family physician practices should still be preparing for the transition.

CMS has produced four handbooks with step-by-step instructions to help small and medium-sized provider practices, large practices, small hospitals, and payers move to the new coding system. CMS also offers several templates that can guide your practice to ICD-10. For example, small or medium-sized practices might want to use the "Vendor Checklist Case Template" when discussing ICD-10 with vendors to determine whether the billing systems are ready for the new diagnosis codes.

Resource: To access the guidebook for small and medium practices, visit www.cms.gov/ICD10/Downloads/ICD10SmallandMediumPractices508.pdf. For more on CMS's transition documents, check out www.cms.gov/ICD10/.

Rural Health List Gets Updated

If you work for a rural health provider, know that you're not alone. Verify your information and learn of other providers in your state by reviewing the 2012 list of rural health providers from CMS. Go to the CMS rural health center http://www.cms.gov/center/rural.asp and click on "Medicare Certified Rural Health Clinics" link under "Contacts."

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