The Certification Commission for Health Information Technology (CCHIT), Chicago, Ill. and the Drummond Group Inc. (DGI), Austin, Texas, were named today by the Office of the National Coordinator for Health Information Technology (ONC) as the first technology review bodies that have been authorized to test and certify electronic health record (EHR) systems for compliance with the standards and certification criteria that were issued by the U.S. Department of Health and Human Services earlier this year.

Announcement of these ONC-Authorized Testing and Certification Bodies (ONC-ATCBs) means that EHR vendors can now begin to have their products certified as meeting criteria to support meaningful use, a key step in the national initiative to encourage adoption and effective use of EHRs by America’s health care providers.

“Less than two months following the issuance of final meaningful use rules, we have approved our initial ONC-ATCB certifiers.  EHR vendors can begin immediately to get their products certified.” said David Blumenthal, M.D., national coordinator for Health Information Technology.  This is a crucial step because it ensures that certified EHR products will be available to support the achievement of the required meaningful use objectives, that these products will be aligned with one another on key standards, and that doctors and hospitals can invest with confidence in these certified systems.”

Applications for additional ONC-ATCBs are also under review.

Certification of EHRs is part of a broad initiative undertaken by Congress and President Obama under the Health Information Technology for Economic and Clinical Health (HITECH) Act, which was part of the American Recovery and Reinvestment Act (ARRA) of 2009.  HITECH created new incentive payment programs to help health providers as they transition from paper-based medical records to EHRs.  Incentive payments totaling as much as $27 billion may be made under the program.  Individual physicians and other eligible professionals can receive up to $44,000 through Medicare and almost $64,000 through Medicaid.  Hospitals can receive millions.

To qualify for the incentive payments, providers must not only adopt, but also demonstrate meaningful use of, certified EHR systems.  The law envisions that defined meaningful use requirements will help ensure that the patient and provider benefits of EHRs are realized.  Initial meaningful use criteria were defined in a final rule issued by the Centers for Medicare & Medicaid Services (CMS) on July 28.

In addition to the CMS rule, ONC also issued standards and certification criteria for EHRs on July 28, aimed at ensuring that EHR systems will support the specific tasks required under meaningful use.  Also, through regulations issued on June 24, ONC created a system by which technology review organizations could also qualify as ONC- ATCBs that will certify EHR products as meeting the requirements necessary for meaningful use.

With the initial two ONC-ATCBs now named, EHR vendors can apply to them for certification of their products.  By purchasing certified products, providers will have assurance that the products will support achievement of the meaningful use objectives.

“Multiple steps are underway to carry out the intent of Congress in supporting rapid and effective adoption of EHRs throughout our health care system,” Dr. Blumenthal said.  “The naming of initial ONC-ATCBs is one important step.  Actual certification of multiple vendors’ systems by the ONC-ATCBs is an important next step.  CMS is also working to create an online system for providers to register and attest for the EHR incentive programs. The first incentive payments are targeted to be made in May 2011.  Meanwhile, ONC is also carrying out new programs of technical assistance and training, especially for smaller hospitals and physician practices.”

Dr. Blumenthal said the Health IT initiative “is on an aggressive schedule to meet the urgent targets set by Congress and the President toward realizing the quality and safety improvements that we can achieve through health information technology.”

To learn more about the ONC-ATCBs named today visit www.cchit.org and www.drummondgroup.com.

For more information about the ONC certification programs visit http://healthit.hhs.gov/certification.

For more information about other HHS Recovery Act Health Information Technology funding and programs, visit http://www.hhs.gov/recovery/programs/index.html#Health.

Source: http://www.hhs.gov/news/press/2010pres/08/20100830d.html

CGI Technologies and Solutions, Inc. – the RAC for Region B – yesterday issued a list of the 18 medical necessity reviews recently approved by CMS for audit. CGI on Aug. 6 received approval from CMS’ New Issue Review Board to begin auditing the 18 inpatient hospital claims listed below. CGI has begun posting these audits to its RAC webpage and will soon begin requesting medical records for these audits. The information below will be provided on the CGI website, in addition to related details per condition, such as the particular MS-DRGs and specific Medicare policies to be considered for these medical necessity reviews.

The 18 approved medical necessity reviews are:

• Chest Pain
• Other Circulatory System Diagnoses, w/ MCC
• Other Vascular Procedures, w/ CC, w/o CC/MCC
• Syncope & Collapse
• Red Blood Cell Disorders, w/ MCC
• Atherosclerosis w/ MCC
• Heart Failure & Shock, w/MCC, w CC and w/o CC/MCC
• Esophagitis, Gastroenteritis & Misc Digestive Disorders, w/ MCC
• Musculoskeletal Disorders*
• Chronic Obstructive Pulmonary Disease
• Respiratory*
• Nutritional and Metabolic Disorders
• Kidney & Urinary Tract Infections, w/MCC
• GI Disorders*
• Percutaneous Cardiovascular Procedures
• Renal Failure
• Nervous System Disorders*
• Cardiac Arrhythmia & Conduction Disorders, w/MCC or w/CC*

* medical necessity reviews excluded for some MS-DRGs associated with this condition

Next Steps
The AHA encourages hospitals in the other three RAC regions to monitor their RAC’s website for information on medical necessity audits. At this time, we are waiting for details on the number and type of medical necessity reviews approved by CMS for RACs in regions A, C and D. Contact information for the four regional RACs is below.
RAC Region A
Diversified Collection Services, Inc.
Livermore, California
1-866-201-0580
Email: info@dcsrac.com
Website: www.dcsrac.com

RAC Region B
CGI Technologies and Solutions, Inc.
Fairfax, Virginia
1-877-316-RACB
Email: RACB@cgi.com
Website: racb.cgi.com

RAC Region C
Connolly Consulting Associates, Inc.
Wilton, Connecticut
1-866-360-2507
Email: RACinfo@connollyhealthcare.com
Website: www.connollyhealthcare.com

RAC Region D
HealthDataInsights, Inc.
Las Vegas, Nevada
Part A: 866-590-5598
Part B: 866-376-2319
Email: racinfo@emailhdi.com
Website: racinfo.healthdatainsights.com

Further Questions
For more information on the RAC program, visit www.aha.org/rac

Source: American Hospital Association

The report indicates that the recently approved audits include 18 types of inpatient hospital claims and one type of durable medical equipment claim. The report did not announce specific issues or indicate which of the four RAC contractors were approved, but CMS did state that the new audit issues would be posted on the RAC Web sites, adding that contractors would begin to issue ADRs (Additional Documentation Requests) within the next two weeks.

Read more here.

Source: MHA News Now

In this issue…

• Measuring Coding Effectiveness
• What is a RAC audit?
• Coding “Rule Out” Diagnosis
• RAC Approved Issues
• Questions & Answers

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• ICD-10 and 5010
• RAC Updates
• Management of External Coding Audits
• Various Coding Q&A’s
• Employment Opportunities

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• ICD-10 and 5010
• RAC Updates
• Management of External Coding Audits
• Various Coding Q&A’s
• Employment Opportunities

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H.I.M. ON CALL is pleased to announce the upcoming open enrollment to our ICD-10 Academy.

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ICD-10 Academy Curriculum

Day 1
- Introduction to ICD-10- CM coding scheme
- Anatomy and Physiology 101 review
- Blood and Blood Forming Organ Disorders
- Neoplasms
- Diseases of Digestive System
- Endocrine, Nutritional and Metabolic Diseases
- Infection and Parasitic Diseases

Day 2
- Mental and Behavioral Disorders
- Disease of the Respiratory Systems
- Diseases of Skin and Subcutaneous Tissues
- Diseases of the Nervous Systems
- Diseases of the Circulatory Systems
- Diseases of the Genitourinary System

Day 3
- Diseases of the Musculoskeletal and Connective Tissues
- Pregnancy, Perinatal and Child Birth Conditions
- E- Codes and injuries, poisoning, and external causes of Morbidity
- Health status and health services
- Summary and review of Diagnosis and Conditions as taught above and test cases
Day 4
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- Review of anatomy 101
- Extractions

Day 5
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- Detachments

Day 6
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- Nonsurgical procedures

Day 7
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In this issue…

• Measuring Coding Effectiveness
• What is a RAC audit?
• Coding “Rule Out” Diagnosis
• RAC Approved Issues
• Questions & Answers

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In this issue…

• Measuring Coding Effectiveness
• What is a RAC audit?
• Coding “Rule Out” Diagnosis
• RAC Approved Issues
• Questions & Answers

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