Archive for November, 2011

Electronic Prescriptions Continue Upward Trend

23 Nov

Last summer, we mentioned data that suggested e-prescriptions are on the rise. Surescripts, which operates the nation’s largest e-prescription network, stated that about 36 percent of physicians file prescriptions electronically. However, that number increased by about 70 percent from 2009 to 2010.

That trend appears to be continuing as Surescripts just announced that over 52 percent of office-based doctors are now use e-prescribing.

E-prescriptions are seen by many as an important step in the evolution of our healthcare system. They make for a more accurate, reliable and secure electronic prescription system and also allow prescribers to access important information regarding their patients’ medications and health plan coverage.

Here’s the latest data from Surescripts regarding the growth of e-prescribing nationwide:

  • 52 percent (291,000) of all office-based physicians now actively use e-prescribing compared with fewer than 10 percent three years ago
  • There are 357,000 active prescribers on the Surescripts network (including office-based physicians, nurse practitioners and physician assistants)
  • 94 percent of retail pharmacies nationwide are now connected and receiving e-prescriptions

And finally, here is the list of the top 10 states with the highest rate of e-prescribing:

1.  Massachusetts                
2.  Delaware                
3.  Michigan                    
4.  Connecticut                    
5.  Rhode Island                    
6.  Pennsylvania
7.  South Dakota*
8.  Iowa*
9.  Oregon*
10. North Carolina*

(*New to the top 10)

“In the next five years, we are going to see electronic health information exchange of all types – e-prescribing, clinical summaries, population health – become commonplace and become the rule rather than the exception,” said Dr. John Halamka, chief information officer at Beth Israel Deaconess Medical Center in Boston.


2012 HCPCS II Now Available, More Than 430 Changes

16 Nov

The Centers for Medicare & Medicaid Services (CMS) recently released the HCPCS Level II codes that go into effect January 1, 2012. Among the changes are 285 code additions (plus one new modifier), 48 revisions, and 75 deletions. Another 18 codes were added and eight deleted throughout 2011.

The policy requires hospitals to combine the charges and appropriate codes for any outpatient diagnostic and “related” non-diagnostic services, not including ambulance and maintenance renal dialysis, provided within the three-day period immediately preceding an inpatient admission.

Many C and Q codes have been deleted and replaced by new J codes, including C9272 being replaced by J0897 Injection, denosumab, 1 mg; Q2040 replaced by J0588 Injection, incobotulinumtoxin A, 1 unit; and Q2042 replaced by J1725 Injection, hydroxyprogesterone caproate, 1 mg.

There have been a few C codes added for 2012, including C9287 for the lymphoma drug brentuximab vedotin and C9366 for the membrane/skin allograft EpiFix®. Similarly, there are fewer than a dozen new drug/supply Q codes for 2012. Among them are Q0162 for the anti-nausea drug ondansetron, Q2043 for sipuleucel-T, a therapeutic vaccine for prostate cancer, and nine new codes (Q4122-Q4130) for skin substitutes such as Dermacell®, Alloskin™ RT, and Talymed™.

  • A series of new E codes (E0988, E2358-E2359, and E2626-E2633) describe various accessories (e.g., batteries, arm supports) for manual and power wheelchairs.


  • Four new K codes (K0743-K0746) have been added for home suction pumps and supplies for wound healing (i.e., negative wound pressure therapy).


  • G codes for telehealth consultations (G0425-G0427) have been revised to apply both to initial and emergency department services.

The largest number of changes (209 additions, 27 revisions, and 28 deletions) affects G codes used to report quality indicators for the Physician Quality Reporting System (PQRS). Eligible professionals (EPs) who successfully report on quality measures in the PQRS are eligible for a 0.5 percent Medicare payment incentive for years 2012-2014. In 2015, EPs and groups that don’t report quality data successfully will face a 1.5 percent payment reduction in Medicare payments, and a two percent reduction for 2016.