PCC Client Lobby

We recently learned that the plan to replace the decades old ICD-9 code set with the new ICD-10 set of diagnosis and procedural codes on Oct. 1, 2013 has been put on hold. The Department of Health and Human Services says it wants to delay implementation because health care providers need more time to prepare.

Officials have yet to issue a new implementation date, but we'll continue to offer resources that will help your office be proactive in preparing for the switch to the much larger, more modern code set.

Here is a starter list of resources. The list will be updated as new information and resources become available.

● FREE Code converter: The ICD-10 code online translator tool allows you to compare ICD-9 to ICD-10 codes. ICD-9 is being expanded from 17,000 to approximately 141,000 ICD-10 codes, and this online tool can help you map that expansion.      

http://www.aapc.com/ICD-10/codes/index.aspx

● FREE World Health Organization Learning Tool: The WHO Electronic ICD-10-training tool is designed for self-learning,and classroom use. The modular structure of this ICD-10 training permits user groups specific tailoring of courses on individual paths, if desired. Detailed information is given in the introduction of the tool, and in the user guide.     

http://apps.who.int/classifications/apps/icd/icd10training/

● ICD-10 Implementation Guide for Small and Medium Practices: Centers for Medicare and Medicaid Services (CMS)

Implementation Guide

● ICD-10 Transition: An Introduction: CMS

ICD-10 Transition

● FREE training videos at codapedia.com: You'll need to become a member, but it's free. Once you log in, you'll have access to free ICD-10 training sessions by coding instructor Nancy Maguire

http://codapedia.com/login.cfm

Carrie Gillander: Sponge Bob Square Pants

Jan Blanchard: Cowgirl

Douglas Beagley: Doctor Who

Lynne Happe: Open Source Software

Simonne Gratton: Geisha

Jen Loiselle: Raggedy Ann/Andy

Deb Bergeron: "Very Happy" Clown

Zach Zilius: Homemade Chicken Costume/Folding Chair

Chip Hart: Executioner

Kristen Ryan: Pirate

Jill Fahy: Lederhosen

Romni Palmer: Roman Gladiator

Erica Greenwood: Pink Panther/Gypsy

Phil Greenwood: Never Dressed Up

Are you and your office staff prepared to properly implement the new immunization administration codes?

On Jan. 1, 2011, new CPT codes 90460 and 90461 will replace codes 90465-90468.

The new coding guidelines say that administration coding should reflect the number of diseases immunized against as well as the number of shots. The work and the responsibility of administering a vaccine is now measured by both the antigens and the supplies, personnel, and other expenses inherent to the task.

To prepare Partner and train your staff, we've put together a comprehensive document that covers all aspects of the new codes, including an overview of administration codes and the changes; billing and posting; Partner configuration changes and new features; and possible pitfalls involving insurance companies.

Read the documentation now at learn.pcc.com/immsadmin2011

Download our Support Form to request help updating your Partner system.

If Marion Hayes could offer one piece of advice to fellow office
managers about PCC's Autopost Insurance Payments program, it would be, “give it a try.”

Pediatric and Adolescent Care of Silver Spring, where Hayes works, was one of the first PCC practices to sign up for the program that takes incoming payments and adjustments, posts all the simple ones, then creates a separate report for claim responses that need manual attention.

A year later, the billing process at PACSS has become a lot easier and more accurate, according to Hayes.

Before autopip, it would take staff all day to post a Blue Cross and Blue Shield voucher of 34 pages. Now, the same process can be completed in two hours, sometimes less, said Hayes.

Hayes said anyone using autopip should run it in conjunction with Partner's allowedit program, which monitors each payer's contracted fee. If a CPT code is not paid according to the practice's contractual fees, it won't post.

“We have already caught one insurance company changing our fees without notice, and anothernot living up to the contract they signed,” Hayes said. “Would this have caught if we did not have autopip? Perhaps, but we caught it immediately with autopip. It helps us keep an eye on the insurance company and keeps them honest.”

Since its launch in October 2009, 56 practices have signed up for autopip. Current users include large practices that employ several billers; smaller offices,where the office manager might play multiple roles; and practices in between.

“Autopip frees your time up by removing the most mundane aspects of posting insurance payments,” said Justin Ballou, project manager for PCC's Electronic Data Interchange team. “Anything with the slightest discrepancy goes to manual posting.”

When a biller runs autopip, he or she can be sure that only those payments and adjustments that match outgoing claims will be cued up on the autopost list, said Ballou.

Anything else – a claim that was denied; a CPT code or charge amount doesn't match a charge history; a claim total is negative; a payment or adjustment is not attributed to a specific charge – will appear on the manual report.

At PACSS, the number of checks that automatically post versus those that need manual attention is about 50/50, said Hayes.

Ballou said the average practice using autopip will see anywhere from 50- to 75 percent of its ERAs autoposted.

As more practices sign on to the program, Ballou added, PCC's exposure to the nuances of different payers will help developers improve the speed and accuracy of the system.

At PACSS, the use of autopip has freed up billers to spend more time reviewing unpaid claims. Autopip has also decreased the types of billing errors that were common with manual posting, said Hayes.

When processing ERAs, Autopip takes into account the payer fee schedules that are posted in Allow Edit. Prior to Autopip, Hayes said, it was easier for a biller to mistakenly post an EOB that included the wrong fee for service.

While using allowedit to maintain up-to-date fee schedules for every insurance company is not necessary for Autopip to run, it is well worth the effort, said Hayes.

“Keeping fee schedules up-to-date is a little time consuming, but you're also making sure you're getting paid correctly,” Hayes said. “I love Autopip. I think it's a great tool, and I wouldn't do without it.”

Hayes encourages any practice that is manually posting to consider Autopip.

“I would say take time to see how the system works,” said Hayes. “Once you do that and see that it's posting correctly, your confidence in autoposting will build.”

In 2007, PCC's Practice Vitals Dashboard web-based reporting tool offered the basics. In a nutshell, clients could log-in to see and compare their practices' revenue and sick-to-well visit ratio with that of other pediatric practices.

Three years later, the Dashboard's menu of reports on pediatric benchmarks has grown from basics to bells-and-whistles. In the past year, 60 percent of PCC's clients have logged in, at least once, to view an expanded offering of clinical measurements, including well-visits and asthma reporting.

The Dashboard's newest quality measurement, called the Childhood Immunization Status, reports on the percentage of patients who have had the CDC-recommended immunizations by their second birthday. The measurement was highlighted at this month's AAP National Conference and Exhibition in San Francisco.

Read more about the Childhood Immunization Status Report

Each year in October, the Director of NCHS and the Administrator of CMS approve the release of new ICD-9 codes and revisions of existing ICD-9 codes.  New and updated codes should be used beginning on October 1, 2010.  

The list of new and updated codes is sometimes long, and not all codes apply to pediatric offices. PCC's Certified Pediatric Coder, Jan Blanchard, reviewed the list of updated codes to identify popular codes used by pediatric offices.  You may find the following list helpful as you prepare to use the new codes in your office.   Your practice management and electronic health record systems may both need to be updated in readiness for these new and updated codes.  

Read More

The next regular release of Partner begins in June. This release, Version 4.1, includes a redesigned Partner Recaller reporting interface to make it easier for you to define and reuse the reports you need to recall patients.

Read the complete Partner 4.1 feature list and review the online documentation for the new Patient Recaller which includes a step-by-step Physical Recall guide.  Also, PCC is offering three weblabs in June about the new Recaller to help you get started with using this newly improved feature of your Partner software.

NEW at learn.pcc.com!  Check out the Patient Recall Video. This video reviews the new features via a walk-through of two sample patient recall projects.  

The roll-out of Partner Version 3.2010 will  be complete in early May.

In the second half of this month, we'll be automatically updating all PCC client offices with a mini-release of Partner, comparable to what you may think of in your office as a "recheck." This release contains a number of small enhancement requests and bug fixes from the update. Doing these smaller mini-release more frequently will minimize disruption to your office.

Coming soon in June will be the next release of Partner, which includes several feature requests as well as a redesigned Partner Recaller reporting interface to make it easier for you to define and reuse the reports you need.  We will be reaching out to several offices to ask for your participation in testing this newest Partner release.

Keep an eye on your InsidePCC Email in the coming weeks for the detailed feature list of the next Partner release and links to online education materials that will help you to learn about new features.

At PCC, we strive to provide pediatricians with tools and information to maintain a healthy bottom-line. With this goal in mind, we have a new survey aimed at capturing practice cost data for pediatric practices of all sizes.

Using the results, we will provide you with the cost and staffing benchmarks that you need to make informed decisions for your practice. All participants who fully complete the survey will receive a summary of the results, along with a customized report comparing your practice's data with pediatric benchmarks, provided we receive a meaningful sample size.

This is an in-depth survey that will prompt you for specific information about your staffing levels and costs. You can save your answers and return to the survey later, as well as download a printable copy of the full survey.

Please submit your survey results by May 15. Your participation will help us obtain valuable practice cost data that will benefit your practice and other pediatric offices!

Participate in the survey.