Week in Review
Important ICD-10 Code Changes Now in Place
October 1 Brought New Changes to ICD-10… Are YOU Ready?
The ICD-10-CD code set, which was put into use October 1, 2015, has been updated, with some codes being eliminated and new ones being introduced. This is very important information for you! If you use a code that has been eliminated, it can result in your claims being denied!
Most of these changes will not apply to chiropractors, but there are some changes that could put your reimbursement at risk if you don’t adjust your coding. The easiest way to find these new codes, and determine whether they will affect your office, is from our friends at ChiroCode Institute. They have a list of the 70 code changes most likely to impact chiropractic offices.
To print a copy of this list:
- Go to www.chirocode.com
- Click on “Blogs” from the top menu
- Click on “Top ICD-10 Code Changes for Chiropractors in 2017”
- Print the list
In addition, ChiroCode has a free webinar on the changes available on their website.
In addition, Wisconsin Physicians Services (WPS) has published an updated Medicare Local Carrier Determination (LCD) that incorporates these new codes. You can access this new version of the LCD on the MAC website. Just go to www.chiromi.com and click on “Medicare LCD Effective 10/1/2016 [Includes ICD-10].” It can also be accessed through WPS’s Medicare site, www.wpsmedicare.com.
Just like the evolution of the ICD-9 code set that was replaced by ICD-10, the ICD-10 code set will continue to evolve. You can expect that there will be small changes to the code set every October 1st. We will keep you updated!
MAC Week In Review | July 17, 2017
Important No-Fault Decision & Human Trafficking Update!
Important News for DCs Regarding No-Fault Court Decision
Moving Forward After the Troubling “Covenant” Decision
In the June edition of the MAC eJournal, we told you about a recent Michigan Supreme Court decision that prohibits medical providers from suing no-fault insurance companies on behalf of auto accident patients for payment of services rendered. This troubling decision pits patients against providers when insurers refuse to pay and marks a radical departure from more than 20 years of case law from the Michigan Court of Appeals.
Unfortunately, the Court offered little guidance on critical issues surrounding the implementation of their decision. The MAC is working with noted auto no-fault legal expert and MAC member benefit attorney Leslie Kohn on strategies chiropractors with lawsuits against auto no-fault companies for unpaid patient bills can use moving forward. For an article from Mr. Kohn on this important topic, go to the MAC home page, www.chiromi.com, scrpoll down to “Important Members Only Resources,” and click on “Kohn Covenant Article.”
MAC-Developed Human Trafficking Training Course Available to Members AT NO CHARGE
The Michigan Public Health Code now requires health profession licensees and individuals seeking licensure to complete training in identifying victims of human trafficking. Beginning with the November 2018 renewal cycle (December 1, 2016 – November 30, 2018), and all renewal cycles thereafter, licensees must have completed this one-time training in identifying victims of human trafficking.
The MAC has developed a PowerPoint/webinar presentation that will satisfy this requirement. It is available by going to the MAC website, www.chiromi.com, scrolling over “Events,” and clicking on “Webinars.” Then click on “Course Catalog” and scroll down to the Human Trafficking webinar. It should take about 10 minutes to complete.
Upon completion of a short quiz, a certificate of completion will be issued to everyone who finishes the course for their records. A copy of the certificate will also be kept in the member’s continuing education file at the MAC office.
Online Registration for MAC Fall Convention NOW OPEN!
This September, the MAC is heading to Motown for the Fall Convention & Exhibition! Amazing speakers like Dr. James Chestnut, Dr. Billy DeMoss, Dr. Francis X. Murphy, Dr. Terry Yochum, Dr. Fab Mancini, Mr. Bill Esteb, and many more will be on hand as the MAC continues our 10th Anniversary celebration at the beautiful Renaissance Center in Detroit!
For more information or to register for the Fall Convention, go to www.chiromi.com/conventions.
New MAC Perk: Drive Data Recovery
Drive Data Recovery (DDR) is the nation's leader in data recovery services, with a network of 73 facilities staffed with expert technicians dedicated to helping you get your life back on track when you think your data is lost forever. They are experts in recovering data from desktop/laptop hard drives and SSDs, RAID arrays, servers, mobile phones, tablets, and USB storage devices.
MAC Perks Discount Offer: In addition to DDR’s standard no-cost evaluation/diagnostic service, first-time clients will receive a 15% discount on data recovery services when they mention MAC-DATA in person, on the phone, or via the “get help form” on the DDR website. DDR is proud to be a member of the community and is happy to share our expertise! Contact Drive Data Recovery by phone at 1-866-315-3282. Their website is https://www.drivedatarecovery.com.
Medicare 2017 Fee Schedule Now Available!
Rates Effective January 1, 2017 - December 31, 2017
WPS Medicare recently released the 2017 fee schedule for dates of service January 1 – December 31, 2017. The new fee schedule reflects changes passed by Congress in the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. MACRA repealed the Sustainable Growth Rate (SGR) formula, the cause of potential huge cuts to the fee schedule providers have been dealing with for more than a decade.
Locality 01 (Macomb, Oakland, Washtenaw, and Wayne Counties)
|Procedure Code||Par Amount||Non-Par Amount||Limiting Charge|
Locality 99 (All Other Michigan Counties)
|Procedure Code||Par Amount||Non-Par Amount||Limiting Charge|
|Medicare Deductible for 2017: $183|
Electronic Health Records Incentive Program Penalties
All Medicare eligible professionals who do not adopt and successfully demonstrate meaningful use (MU) of a certified electronic health record (EHR) technology are subject to a reduction in the Medicare physician fee schedule amount for covered professional services.
The adjustment for 2017 (based on demonstration of MU in 2015) is 98% of the Medicare physician fee schedule covered amount. Providers could face additional decreases in 2018 and each subsequent year, based on demonstration of MU in 2016 and subsequent years. Depending on the total number of Medicare eligible professionals who are meaningful users under the EHR Incentive Programs after 2018, the maximum payment adjustment can reach as high as 5%.
Physician Quality Reporting System (PQRS) Payment Adjustments
Eligible professionals who do not satisfactorily report data on quality measures for covered professional services will be subject to a continued payment adjustment under PQRS in 2017.
The PQRS payment adjustment applies to all of the eligible professional’s Part B covered professional services under the Medicare Physician Fee Schedule (PFS). For 2017 and subsequent years (based on participation in 2015 and subsequent years), the payment adjustment is 2.0%.
Expanded Medicare Fee Schedule Available
If you did not participate in the EHR Incentive Program, PQRS, or either program, an expanded Medicare fee schedule reflecting the above penalties for 2017 is available to MAC MEMBERS ONLY. Contact Tim at the MAC office at firstname.lastname@example.org or (517) 367-2225 or visit the Medicare section of this website for the expanded fee schedule.
Source: WPS Medicare