Category Archives: Industry

Compliance Update: Alternative Reporting Models

Here’s an update on some MIPS reporting rules for providers under certain Alternative Payment Models: 

Do I have to submit the measure data for Advancing Care Information Category measures if I am part of the Medicare Shared Savings Program (Tracks 1, 2 and 3)?

If you are part of the Medicare Shared Savings Program (Tracks 1, 2, and 3), you must submit ACI at the TIN level through group reporting.

What if my ACO does not successfully report quality measures through the CMS Web Interface?

While unlikely, since most ACOs successfully report quality measures through the CMS Web Interface, if you believe your ACO won’t report what it needs to under the Shared Savings Program, your group can submit quality data under your group’s TIN for the performance year under any of the MIPS standard reporting options.

If the ACO doesn’t meet its reporting requirements, CMS will look for and use any other quality data that may have been submitted. This means you can submit your quality data via gGastro eCQMs or via another route as a backup.

Questions?
For further questions regarding APMs, group reporting, or ACOs, please visit qpp.cms.gov or email qpp@cms.hhs.gov.

Here are some other CMS resources:

CMS Releases Lookup Tool to Help Clinicians Determine their MIPS Participation Status

Unsure of your participation status in MIPS? The CMS Quality Payment Program website has an interactive tool clinicians can use to determine if they should participate in the MIPS track of the Quality Payment Program in 2017.

The CMS tool can be found on the Quality Payment Program website.

For more information, contact CMS Quality Payment Program directly at 1-866-288-8292 email QPP@cms.hhs.gov.

ICD-10 code updates effective October 1, 2016

2017 ICD-10-CM diagnosis code updates go into effect October 1, 2016.

gGastro’s ICD-10 Codes Search feature references the Health Language search engine. gMed received the updates provided by Health Language and has published the codes to the application as of October 1, 2016 .

Please note: any retired or modified codes that may be part of the customized user list configuration will have to be manually updated by each organization. Users with appropriate permissions can edit the existing codes or add new codes to their user lists / favorites as necessary.

For help on updating your user list items reach out to gsupport@modmed.com.

CPT code updates effective January 1, 2017

The American Medical Association has published new guidance on CPT codes for 2017. The gMed team is in the process of reviewing and incorporating the necessary changes into the application. We expect the code updates to become available to all gMed clients without a need for an upgrade.

The CPT codes database, as well as the coding logic engine which drives the automatically generated CPT codes for the GI procedures, are centrally hosted by gMed and should be updated January 1, 2017.

Upon completion of the review, the gMed product team will share a summary of the most impactful changes to the GI codes to help you prepare for the transition.

For questions reach out to gsupport@modmed.com.

Hardship Exception Period Extended: November 30th, 2014

On October 7, 2014 Centers for Medicare and Medicaid reopened the Hardship exception submission period, which had previously ended on July 1, 2014 and extended it until November 30, 2014.

This extension of the submission period is meant for:

  • Any EPs and EHs that have been unable to fully implement 2014 Edition CEHRT due to delays in 2014 Edition CEHRT availability, and
  • First time MU participant EPs who were unable to attest by Oct. 1, 2014 using the flexibility options provided in the CMS 2014 CEHRT Flexibility Rule.

For more information, refer to the CMS website for Payment Adjustments and Hardship Exceptions