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Physician Practices follow these steps to enter the e-prescribing era
by: Torrey Kim
Can your physician do without adopting e-prescribing? If your practice still has not applied electronic prescription processes, then you could be missing out on two percent Medicare bonus� as well as preventing prescription errors and lowering consumer costs. Here are three simple steps to guarantee an easy transition.
Backdrop: Payers and health plans havepushed for new incentives for electronic prescription last year. For example, starting January 2009, Medicare has paid physicians a bonus if they swapped their prescription pads over to e-prescribing. Various private health plans have also offered additional payments along with free equipment (i.e., digital handheld devices).
There is free software available courtesy of technology companies, given away to encourage physicians to take the electronic route. Keep in mind that free software usually provides what you paid for it. For example, there�s little to no support or training when you sign up for free solutions.
According to Web sources, the number of physicians prescribing medicines electronically has more than doubled in the last year to about 70,000, or about 12 percent of all office-based physicians. The increase is credited mainly to the incentives introduced at the start of the year. Do not be among the 88 percent still holding out in 2010 while throwing out two percent of your Medicare income and perhaps other bonuses from private payers.
Step 1: Ask yourself what e-scribing system you�re using
Before you get going, it�s significant to ask yourself if you want to practice e-prescribing using a stand-alone system or one that is part of an EHR (electronic health records). According to Barbara J Cobuzzi, MBA, CPC, CENTC, CPC-H, CPC-P, CPC-I, CHCC,botanical slimming jogja, president of CRN Healthcare Solutions in Tinton Falls, N.J., you should measure the pros and cons, as follows:
Stand-alone systems are the least expensive and they�re the quickest to implement, however
EHRs have added features that are helpful in managing a medical practice over the long run.
Stand-alones will allow the practice to be up in time for 2010 to maximize the bonus.
Stand-alone systems may have the capacity to interface with a PM or EHR system.
The practice can then convert from a stand-alone system to an integrated system when an EHR is implemented, providing the practice the best of both worlds, speedy implementation of e-prescribing and finally the benefits of an integrated system with an electronic health record.
CMS�s acting administrator Kerry Weems had earlier anticipated the cost of an e-prescribing system to be about $3,000 per prescriber. To add to it, practices will face recurring costs for the dedicated internet line and maintenance that the systems require, which could cost you between $80 and $400 per month.
The good news is: You don�t have to have an EMR (electronic medical record) system to e-prescribe. You can find stand-alone e-prescription systems, like online options, that are substantially less costly than a full-blown EMR.
Red flag: Moreover, if you are adopting e-scribing, you certainly need to check the regulatory requirements of your state. Stay in touch with state officials and ensure you comply with any applicable e-prescribing requirements specific to your state.
Step 2: Bill 1 of the denominator codes
Your first step is to report one of the following denominator codes:
E/M service codes 99201-99205 and 99211-99215;
Outpatient consultation codes 99241-99245; or
G codes G0108 (Diabetes outpatient self-management training services, individual, per 30 minutes) or G0109 (Diabetes selfmanagement training services, group session [two or more], per 30 minutes).
You need to report any of these codes on the claim for each patient visit during the reporting period that meets the denominator coding criteria,botanical slimming jogja.
Step 3: Report G8443-G8446 as the numerator:
If your practice operates a qualified e-prescribing system, report one of the following G codes on more than 50 percent of applicable Medicare cases for the numerator:
G8443 � All prescriptions formed during the encounter were generated by means of a qualified e-prescribing system
G8445 � No prescriptions were generated during the encounter, but the provider does have access to a qualified e-prescribing system
G8446 � The provider does have access to a qualified e-prescribing system, but some or all prescriptions generated during the encounter were printed or phoned in as called for by state or federal law or regulations, patient request, or pharmacy system being unable to get electronic transmission or the prescription was not e-prescribed since it was for narcotics or other controlled substances.
Remember that the applicable �G� code must go on the same claim as the �denominator� service.
For instance: A Medicare patient visits the doctor for chronic serous otitis media. At the end of the E/M service, the physician prescribes an antibiotic through e-prescribing. Here�s how you should report the service:
99213 (Office or other outpatient visit �) linked to 381.01 (Acute serous otitis media)
G8443.
Likewise, a patient visits the doctor for a cold, fearing that it may involve a sinus infection. The doctor determines that the patient is just suffering from a cold, but, and orders only over-the-counter preparations. As the physician writes no prescriptions, here�s how you should bill the visit (a level 2):
99212(Office or other outpatient visit �) linked to 460 (Acute nasopharyngitis)
G8445.
Finally, a patient has chronic migraines owing to his chronic frontal sinusitis. The doctor documents a level 4 service. He orders some prescriptions via escribing, and the physician writes a manual script for Vicodin on a paper script, as it is a controlled substance.
You should go for:
99214 (Office or other outpatient visit �) linked to 473.1 (Chronic sinusitis; frontal)
G8446.
Reap the rewards of e-prescribing
One advantage of electronic prescribing is that it allows physicians to transmit prescriptions through a secure Internet network, through a clearinghouse, and finally to the pharmacies using an office or laptop computer or a digital handheld device. Various studies have shown that e-prescribing reduces prescription errors and brings down costs for consumers and providers.
That apart,botanical slimming jogja, Medicare released the new incentive guideline, which reads: �Physicians who adopt e-prescription systems are entitled to bag a bonus of 2 percent of their total Medicare allowed charges.� The rules on how you will report your e-prescribing, however, is changing in 2010. Effective January 1, you will only report an e-prescribing code when a visit results in an electronic prescription being placed. You will need to report this code at least 25 times during the reporting period in order to be a successful e-prescriber.

About The AuthorTorrey Kim, MA, CPC covers Medicare coding, billing, compliance and Healthcare IT issues in-depth every week as the editor-in-chief of the popular weekly publication Part B Insider, available on Supercoder.com.

Disclaimer: The information presented and opinions expressed herein are those of the authors
and do not necessarily represent the views of ArticleCity.com and/or its partners.

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