Health research firm KLAS says internal medicine doctors report a satisfaction of 7.6 out of 9 for their chosen electronic health record (EHR) systems, making them the  group of physicians most satisfied with their EHR.

The Utah-based research group’s study finds family physicians are nearly as satisfied with their EHR systems. Oncologists and ophthalmologists are least excited about their systems, with a rating of 5.8 out of 9.

In a press release, KLAS research director Mark Wagner said, “Vendors strive to meet providers’ needs and reach the specialty EMR promised land by offering a solution that provides the fewest gaps with the best support for the broadest number of specialties.”

Wagner continued, “Providers also want a solid solution for the critical, high-revenue, and high-volume specialties; strong ambulatory/inpatient data exchange, whether through native EMR integration or HL7 interfaces; and clean code releases built on top of dependable applications that work in tandem with reliable customer support.”

Part A/B Medicare administrative contractor (MAC) Highmark Medicare Services (HMS) is now Novitas Solutions, Inc. Along with the name change, providers in the new jurisdiction H may have to update their electronic funds transfer (EFT) paperwork and their understanding of local coverage determinations (LCDs). Read more »

Medicare will now separately pay for complication services for a person who donates an organ to a Medicare beneficiary, according to the Centers for Medicare & Medicaid Services (CMS) change request (CR) 7816. With customary claims, the patient is always the beneficiary, so the patient relationship has always been a one-to-one match. When a person donates an organ, however, the one-to-one patient relationship no longer exists.

CMS has a temporary workaround to allow 837I claims for organ donor complications into Medicare systems. According to MLN Matters® article 7816, to code claims for organ donor complications during the temporary process, providers should:

• Show the patient relationship of 18 (Self) in Form Locator (FL) 59 (Patient’s Relation to Insured) on all 837I claims.
• Submit the Medicare beneficiary’s information in the following FLs: 08 (Patient Name/Identifier), 09 (Patient Address), 10 (Patient Birth Date), and 11 (Patient Sex).
• Add a value of 39 along with the donor’s name to the 837I Loop 2300, Billing Note Segment NTE02 (NTE01 = ADD).

Providers using the UB-04 paper claim and direct data should:

• Show the patient relationship of 39 (Organ Donor) in Form Locator (FL) 59 (Patient’s Relation to Insured); and
• Submit the Medicare beneficiary’s information in the following FLs: 08 (Patient Name/Identifier), 09 (Patient Address), 10 (Patient Birth Date), and 11 (Patient Sex).

For complete instructions, read CR 7816, or MLN Matters® MM7816.

The Centers for Medicare & Medicaid Services (CMS) now covers transcatheter aortic valve replacement (TAVR) for Medicare patients, under certain conditions.

According to CMS, coverage for TAVR is approved under Coverage with Evidence Development (CED) only for the treatment of severe symptomatic aortic valve stenosis when all of the following five conditions are met:

1. The procedure is furnished with a complete aortic valve and implantation system that has received FDA premarket approval for that system’s FDA-approved indication.
2. Two cardiac surgeons have independently examined the patient face-to-face and evaluated the patient’s suitability for open aortic valve replacement (AVR) surgery; and both surgeons have documented the rationale for their clinical judgment and the rationale is available to the heart team.
3. The patient (preoperatively and postoperatively) is under the care of a heart team: a cohesive, multi-disciplinary, team of medical professionals. The heart team concept embodies collaboration and dedication across medical specialties to offer optimal patient-centered care. TAVR must be furnished in a hospital with an appropriate infrastructure as specified in the decision memo.
4. The heart team’s interventional cardiologist(s) and cardiac surgeon(s) must jointly participate in the intra-operative technical aspects of TAVR.
5. The heart team and hospital are participating in a prospective, national, audited registry that: 1) consecutively enrolls TAVR patients; 2) accepts all manufactured devices; 3) follows the patient for at least one year; and 4) complies with relevant regulations relating to protecting human research subjects, including 45 CFR Part 46 and 21 CFR Parts 50 and 56.

The following outcomes must be tracked by the registry; and the registry must be designed to permit identification and analysis of patient, practitioner and facility level variables that predict each of these outcomes:

• Stroke
• All cause mortality
• Transient Ischemic Attacks (TIAs)
• Major vascular events
• Acute kidney injury
• Repeat aortic valve procedures
• Quality of Life (QoL)

See the decision memo for further specifications about the registry requirements.

CMS is requesting public comments, specifically about the use of CED, on the proposed determination pursuant to section 1862(l) of the Social Security Act. After considering the public comments, CMS will make a final determination and issue a final decision memorandum.

You can read the tracking sheet, proposed decision memo, decision memo, and view public comments documents on the CMS website.

At long last, Medicare is giving physicians who specialize in sleep medicine a little recognition by giving them their own specialty code. The Centers for Medicare & Medicaid Services (CMS) makes new specialty code CØ official in transmittal 2462. The new code is effective April 1, 2012.

Sleep medicine doctors can self-designate their specialty on the Medicare enrollment application (CMS-855I) or Internet-based Provider Enrollment, Chain and Ownership System (PECOS) when they enroll in the Medicare program, or revalidate their enrollment.

Also in this transmittal, CMS establishes sports medicine code 23 for durable medical equipment Medicare administrative contractors (DME MACs) and ViPS Medicare System (VMS). This specialty code has already been established for Part A/B MACs, fiscal intermediaries (FIs), carriers, and regional home health intermediaries (RHHIs) and their respective shared system maintainers in transmittal 2098.

Specialty codes are used by CMS for programmatic and claims processing purposes.