You can use a new CMS online tool to see how close your providers are to meeting stage 1 meaningful use requirements, which would yield $18,000 per provider in federal bonus dollars under the Electronic Health Record (EHR) Incentive Program.

This chart compares specialists’ E/M utilization and denial rates by code level, focusing on the most common (level 3) and the top two levels (4 and 5). NOTE: Primary care is the top biller of E/Ms and was thus not included to emphasize the specialty data. Level 3 E/Ms retain their claim to being the top level billed in terms of sheer volume, accounting for the largest slice of the utilization pie for seven of the 12 specialties analyzed. However, five specialties – cardiology, hematology/oncology, neurology, pulmonary disease and rheumatology – bill more level 4s than level 3s or level 5s.

You might receive an unexpected bonus payment from Medicare thanks to the Primary Care Incentive Payment (PCIP) program, Part B News has learned. It would be unexpected because your providers didn’t actually furnish any primary care. At least one practice in Pennsylvania got a surprise electronic payment worth $2,700 from Highmark, the Medicare Administrative Contractor (MAC). But this practice consisted only of pain management specialists and four physician assistants.

You have just five months to choose an electronic health record (EHR) system, negotiate a contract and make preparations for implementation – any delays will drastically decrease your chances of collecting the first $18,000 bonus check, paid per provider, under the EHR Incentive Program, experts say. To be ready to demonstrate meaningful use on Oct. 1, 2012 – just 17 months from now – you must be ready to have an EHR system installed by October of this year, according to an expert’s roadmap.

Many of your peers don’t believe their practice management software and electronic health records (EHRs) are currently compatible with the new HIPAA 5010 transaction standard, which could leave many fumbling to meet the Jan. 1, 2012 deadline, experts say. Nearly 25% of practices report not knowing what needed to be done with their software to comply with HIPAA 5010, according to a Medical Group Management Association (MGMA) survey.

You must actively seek reprocessing of claims submitted to Medicare for a variety of radiology and diagnostic ultrasound services via skilled nursing facility (SNF) consolidated billing. Almost all 2011 claims for a total of 37 codes in the 76000 range could potentially be impacted, CMS said in a March 21 posting. The majority of these codes are diagnostic ultrasounds, which were billed to Medicare for the professional component (PC) of each service with modifier 26 (professional component) appended.

You have until June 30 to e-prescribe to 10 unique patients or else you’ll be hit by a 1% penalty to all Medicare payments in 2012 – and you won’t catch a break if you were planning to meet this requirement via an electronic health record (EHR) system later this year. Unless you already have a way to e-prescribe, you’ll have to buy a standalone system and meet the 10-patient threshold to avoid the penalty, experts say.

Download this month’s tool – an Electronic Health Record Preparedness Assessment created by the California HealthCare Foundation – to help you estimate how much work awaits you in the EHR implementation process. This tool is widely used by technology consultants to gauge the readiness of a wide variety of practices to adopt an EHR system.