Category: NY Medicaid EHR incentive program

Posted in MVP (NY/VT) Insurance Payer, NY Medicaid EHR incentive program, NY Providers, Payers and CPT reinbursement, Updates

MVP postpartum program incentive payments: NY providers!

Posted on by KR2Medical Billing

Are you any of these following providers in NY?

OB/GYN Family Medicine Certified Nurse Mid-wives Nurse Practitioner – Family Health

Then this blog post is for you!

NY DOH established an additional payment (to global OBGYN bundled payment) for providers that complete a person-centered postpartum visit— including a depression screening—within 12 weeks of delivery, as per ACOG/AAP guidelines.

In order to qualify for this additional payment the postpartum services need to be related to deliveries that occurred from July 1, 2024, through March 31, 2025.

Coding that qualify for this program are:CPT II Code 59430 or 0503F

Please bill these codes with $0

This program only applies to Managed Medicaid Care Plan type.

The additional payment amount is $125.

The payments are maid quaterly basis.

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Posted in NY Medicaid EHR incentive program, Training, Updates

Successful NY Medicaid EHR Incentive Program: Meaningful Use Audit

Posted on by KR2Medical Billing

I am proud to say that after 2 months of working on this project, my client successfully passed an audit for NY Medicaid EHR Incentive Program: Meaningful Use for the year ending 2017

What a fantastic way to start the year!

Summation Letter. Successful Meaningful Use Audit passed!

If you would like to see more of my past or current/coming up projects, please visit my Project Portfolio Page

Posted in HEDIS Measures, MIPS, MU Stage 2 and 3, NY Medicaid EHR incentive program, Training

HEDIS Measure- Controlling High Blood Pressure

Posted on by KR2Medical Billing

Definition: The percentage of patients that are ages 18 to 85 years old, who have had a diagnosis of hypertension (HTN) and whose blood pressure was adequately controlled (<140/90 mm Hg) during the measurement period.

What is Accepted:

DOCUMENT YOUR EFFORTS! Blood pressure and DX of HTN (high blood pressure).

DX code:  I10

Medical Billing and coding:

Code Description
3077F Systolic is greater than/ equals to 140
3074F, 3075F Systolic is less than 140
3080F Diastolic is greater than/equal to 90
3079F Diastolic 80-89
3078F Diastolic less than 80
93784,93788,93790,99091,99453,99454,99457 Remote  Blood Pressure Monitoring codes
98966, 98967,98968,99441,99442,99443 Telephone visits
95, GT      Telemedicine Modifiers/ POS 02 (place of service)

Patients that have BP adequately controlled include:

+Patients 18 to 85 years old who had a diagnosis of HTN and whose BP was adequately controlled during the measuring period

+ Patients who had a most recent BP reading during the measurement period year or had a BP measurement after the second diagnosis of HTN.

If no BP is recorded during the measuring period year, than it is assumed that BP is not controlled.

Exclusions:

1. Patients with ESRD

2. Patients with Nephrectomy or Kidney transplant

3.Pregnant patient

4.Nonacute inpatient stay

5. Patients aged 66 to 80 years old with frailty and advanced illness

6. Patients 81 years old and above with frailty

What is not accepted in this measure:

– If BP was taken on same day as a diagnostic test or procedure  was done or for a change of diet or medication regiment

– If BP was taken a day before or on the same day of any test or procedure

– BP taken during an acute inpatient stay or at the emergency department.