HP-Update 2-7-2012

February 7th, 2012

Dear Colleague:

We want you to know the highlights of the Academy's regulatory advocacy and the latest updates in business of medicine affecting the specialty and your patients. The Physician Payment Policy Workgroup (3P), led by Co-Chairs Richard Waguespack, MD and Michael Setzen, MD, along with your AAO-HNS Health Policy Team, are working hard to advocate for you on socioeconomic and practice affairs.

AAO-HNS Coding Hotline
The Academy offers a coding hotline as a free service to members of the Academy. If you have coding questions or need guidance, this resource can help you!
9 am- 6 pm EST Monday through Friday


Academy Meets with United Healthcare on "Direct to Consumer" Hearing Aids
On January 30th, Academy leadership, physician representatives, an audiologist, staff and representatives met with United Healthcare to express their concerns over the accuracy of the online hearing test currently being offered in roll-out states and ensuring patients receive appropriate otolaryngic physician oversight. For more information, visit the Private Payer Advocacy page here.

Academy Submits Comments on 2012 Medicare Physician Fee Schedule (MPFS) Final Rule
On January 3rd, the Academy submitted comments to the Centers for Medicare and Medicaid Services (CMS) regarding the 2012 MPFS final rule. To see the Academy's comments on the Sustainable Growth Rate (SGR), potentially misvalued codes, and quality reporting initiatives, click here.

Academy Releases Balloon Ostial Dilation Appeal Template Letter
Have you had an entire surgical session for CPT code 31295-31297 (Nasal/ sinus endoscopy. Surgical...) denied? The Physician Payment Policy workgroup has drafted an appeal template letter which members may use to appeal their denials. See the appeal template letter here.

Business of Medicine

Submit 2011 PQRS data through February 17:
PQRIWizard is a new tool available to Academy members to report quality measure data to CMS under the 2011 Physician Quality Reporting System incentive program. PQRIWizard is a simple and cost-effective tool to collect and report quality measure data. The deadline to submit 2011 data through PQRIWizard is February 17. More information on PQRIWizard.

Guidance for Otolaryngologists on 2012 CPT Changes to Sub-Specialty New Patient E/M Billing
For 2012, CPT languate was changed to indicate that two sub-specialties of the same overall specialty may bill for a new patient E/M in situations where they see the same patient. For further guidance, email healthpolicy@entnet.org. For more details, see the CPT codes for 2012 page http://tinyurl.com/7plpnye (login required).

HHS Announces Additional Year to Meet Stage 2 Meaningful Use Criteria
The Department of Health and Human Services (HHS) announced it will delay Stage 2 of the Medicare/ Medicaid Electronic Health Record (EHR) Incentive Program from 2013 to 2014 for those who meet Stage 1 requirements in 2011. For more information on EHR Meaningful Use Criteria, visit the Academy's webpage at http://www.entnet.org/Practice/ONC.cfm

Electronic Health Records (EHR) Incentive Program
The last day for eligible professionals to register and attest "meaningful use" of EHR to receive incentive payments for calendar year 2011 is February 29. For more on EHR Incentive programs, visit the CMS website here.

Are You Version 5010 Complaint?
Last December, CMS announced a three month grace period from enforcing Version 5010 HIPAA transactions. The compliance date for the use of Version 5010 transactions was January 1st, but CMS will not enforce transactions until March 31st. Visit the CMS site on Version 5010 at https://www.cms.gov/ICD10/11a_Version_5010.asp. 

RUC Survey: CPT Code 31231 Received Unprecedented Response from Members
The RUC survey for CPT code 31231 closed on Tuesday with an unprecedented response rate from members that perform Diagnostic Nasal Endoscopy's. The Physician Payment Policy Workgroup (3P and the entire Health Policy team would like to thank everyone that responded and completed this crucial survey.

Upcoming Coding Workshops
Presented by the American Academy of Otolaryngology—Head and Neck Surgery Foundation in conjunction with Karen Zupko & Associates, Inc.
Las Vegas, NV February 17-18

For more Health Policy news, see the Bulletin online at http://tinyurl.com/3u2k53w (login required) or visit http://www.entnet.org/Practice/CMS-News.cfm.


Rodney Lusk, MD


HP Update Issue Archive
HP-Update 11-9-2011
HP-Update 6-29-2011