A bi-weekly newsletter from your physician organization
Friday, Feb. 28, 2020
Providing alternatives to emergency department visits
Emergency department visits increased from 136.9 million in 2015 to 145.6 million in 2016, a jump of 6.4 percent, according to the latest statistics available from the Centers for Disease Control and Prevention. Research conducted by UnitedHealth Group in 2019 revealed the average cost of t reating conditions at a hospital emergency department is $2,032, which is 12 times higher than visiting a physician office ($167) and 10 times higher than an urgent care center ($193).

Lack of access to care, such as a primary care practice not having weekend or evening on-call or availability, can be factors in over-use of the emergency department by patients. Some tips to decrease unnecessary emergency department use include:

  • Educate patients on appropriate use of the emergency department
  • Let patients know if your practice has after hours care available.
  • Alert patients if your physicians are on call after hours
  • Practices can also help patients understand the difference in utilizing an urgent care facility or emergency department.
  • Share information on preferred urgent care facilities. If a primary care office doesn’t offer after hours care, a relationship should be established with at least one local urgent care facility to assist with non-emergent after-hours care.

The Physician Alliance created materials related to urgent care use:

Urgent care poster
Urgent care handout (practices can add customized info)

These materials and others are also available on TPA's website .
CMS fee schedule updates shared in seminar recording
Are you aware of the latest changes to the Centers for Medicare and Medicaid Services' Physician Fee Schedule? These changes strive to recognize clinicians for time spent caring for patients, remove unnecessary measures, and make it easier for clinicians to be on the path towards value-based care.

The Physician Alliance hosted an education seminar highlighting updates to the fee schedule. If you missed the seminar, check out the recording . Additional education videos are available on TPA's website .
Local self-management training workshop available
The Michigan Center for Clinical Systems Improvement (Mi-CCSI) is offering self-management care manager/ care coordinator training.

This course consists of a self-study component to be completed prior to the two day live, onsite training. Topics include: teaching basic self-management to patients, motivational interviewing and introduction to practice based and team-based care management.

Self-Management Training*
Tuesday, May 26; 9am-5pm AND Wednesday May 27; 8am-5pm
Ascension Oakland Hospital Education Building, Madison Heights
*There is a fee for this program.
Coding Corner: Coding for coronavirus
While the number of patients infected with the novel coronavirus is still relatively low in the United States, officials are urging healthcare providers to be prepared for an increase.

The Centers for Medicare & Medicaid Services (CMS) recently took action to ensure America’s healthcare facilities and clinical laboratories are prepared to respond to the threat of the novel coronavirus (COVID-19).

What you need to know:

  • CMS developed a new Healthcare Common Procedure Coding System (HCPCS) code for providers and laboratories to test patients for SARS-CoV-2, effective April 1 (for dates of service on or after Feb. 4, 2020). HCPCS is a standardized coding system that Medicare and other health insurers use to submit claims for services provided to patients.
  • Healthcare providers who need to test patients for coronavirus using the Centers for Disease Control and Prevention (CDC) 2019 Novel Coronavirus Real Time RT-PCR Diagnostic Test Panel may bill with the newly created HCPCS code (U0001).
  • This code will allow those labs conducting tests to bill for the specific test instead of using an unspecified code. This also ensures better tracking of the public health response to help protect people from the spread of this infectious disease.

  • For classifying coronavirus not associated with SARS: 
  • Pneumonia due to coronavirus: J12.89 and B97.29
  • Sepsis due to coronavirus: A41.89 and B97.29
  • Other infection caused by coronavirus: B34.2
  • Contact with and (suspected) exposure to other viral communicable diseases: Z20.828

  • For classifying the SARS-associated coronavirus:
  • Pneumonia due to SARS-associated coronavirus: J12.81
  • Sepsis due to SARS-associated coronavirus: A41.89 and B97.21
On Feb. 6, CMS issued a memo to help the nation’s healthcare facilities take critical steps to prepare for COVID-19. Click here to view a copy of the memo and see more details.

CMS also gave CLIA-certified laboratories information about how to test for SARS-CoV-2. Read more about those efforts.
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