Having said that, I’d like to reveal what I feel are two great changes with regard to the reporting of the utilization of electronic prescriptions to Medicare and the reimbursement for this reporting under the current e-prescribe bonus program.

Beginning on January 1, 2010, if a medical provider electronically prescribes at least one medication electronically, this will be reported with the new e-prescribe HCPCS code of G8553. The prior reporting codes of G8443, G8445 & G8446 will be deleted. This change will eliminate any confusion concerning what code to choose. If you e-prescribe one or more medications, G8553 will be reported. If no prescriptions are electronically prescribed, nothing is reported.

In addition, the qualifying for the incentive bonus payment is about to get easier. Currently, in order to qualify for the e-prescribe bonus, a provider must have a 50% rate of electronic prescribing for all prescriptions generated from his or her practice. For 2010, the physician will only need to electronically prescribe 25 times a year in order to qualify.

There are a few things to take into account as we approach these changes. The reporting code must always be reported with a unique face-to-face patient encounter in order to count towards the 25-visit minimum. Also, the definition of electronic prescribing does NOT include faxes.  

In conclusion, if you want an illustration of negative change, as a resident of Milwaukee, I need only look at where the temperatures stood on Thanksgiving and compare them to today. The temperature has dipped into the low teens, and I’ve spent the bulk of the time trying to stay warm at my desk as I type this by playing the more raucous portions of my mp3 player’s catalog. Who knew that Husker Du’s Zen Arcade had a legitimate business purpose? Sometimes, it is of huge advantage to avoid cliche.

In the rush to digitize health information and medical records, even prescriptions are making the jump from notepad to network. Soon the squinting and scrawling and folding and crumpling of the physician-pharmacist relationship will be replaced by high-speed data delivery from point-of-service, at time of service, direct to the pharmacy.

Fi-Med Management, Inc., a medical billing and financial management company headquartered in greater Milwaukee, announced this week the addition of electronic prescription services to its portfolio of client services.

The service, part of Fi-Med’s Electronic Medical Records (EMR) package, gives physicians the ability to send error-free, electronic prescriptions directly from point-of-care to the pharmacy without ever lifting a pen—a critical component in the improvement of patient care and safety.

Fi-Med’s e-prescription software partner, SequelMed, provides drug and benefit details and patient medication history from prior patient records, even those generated by other physicians and hospitals. Clients also have access to online drug reference guides, reporting capabilities and 24/7 electronic access to patient prescription data.

On January 1, the Centers for Medicare and Medicaid Services (CMS) released e-prescription codes, available here.

Physicians using e-prescriptions may be eligible for a 2% bonus payment at the end of 2009, provided they’re paid at least 10% of total Medicare Part B reimbursement for services in the office, with the consistent reporting of these codes. That bonus will decrease beginning in 2010, and penalties in the form of reduced payments through Medicare Part B are slated to affect physicians not using electronic prescriptions by 2012.

For more information or to subscribe to news affecting physician reimbursements and related services, visit the Fi-Med blog or call 800-318-0019.

The following are the three codes that can be reported in addition to the E/M service for the office encounter:

G8443 – Used when all prescriptions during the encounter were generated using an e-prescribing system

G8445 – Used when there are no prescriptions dispensed during the encounter.

G8446 – Used when some or all of the prescriptions at the encounter were hand-written. This would be due to the affect of state or federal law based on what was prescribed. The prescription of Schedule II drugs (narcotics) falls into this category.

In 2010 and 2011, this bonus will decrease by .5% per year. Beginning in 2012, if you are not prescribing electronically, you face being penalized with reductions in your payments for office services through Medicare Part B.

If you currently do not have the ability to prescribe electronically, there are several vendors who offer technology that will fit the needs of your practice. While CMS does not recommend one vendor more than another, it advises practices to takes into account compliance with the HIPAA rules for privacy and security when choosing software for e-prescribing.

The AMA has comprehensive information available on their website at the following link to assist you in preparing your practice for e-prescribing:

http://www.ama-assn.org/ama1/pub/upload/mm/472/electronic-e-prescribing.pdf

As in every case, I am available to you at any time to assist you with this and other needs of your practice. Feel free to leave a comment or contact me directly.