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Audiology Today E-Newsletter July 2012

Audiology Today E-Newsletter July 2012

July 01, 2012 E-News

 

American Academy of Audiology - Audiology Today
July 2012
 
Let Me Hear from You: Collective and Coordinated Efforts
By Deborah Carlson, PhD
Much like celebrating the New Year, July marks the transition of leadership for the Academy. July 1 marks the start of new leadership terms, as well as the Academy fiscal year. Like New Year's, I view this as a time to pause to recognize the efforts of those during the past year as well as those committed to the upcoming year. Read more…

 

 
The Standards of Practice for Audiology Now Available
The Standards of Practice for Audiology were developed to define acceptable standards of practice for services representing the Academy's Scope of Practice. This document was developed to serve as a resource for both professionals and consumers. These standards reflect the values and priorities of our profession and are continually evaluated and revised to reflect the current state of the profession. Read more…
 
Call for Nominations: Academy Board of Directors and President-Elect
Nominations for president-elect and three Board of Director positions of the American Academy of Audiology are now open and may be made by any member of the Academy. Nominations must be received no later than 5:00 pm ET, August 24, 2012. Read more…
 
Practice Management Tip of the Month: Send Birthday Joy
Patients love birthdays! Send your patients a birthday note or card along with a pack of "birthday batteries" to help show appreciation to your patients. A handwritten card with a signature also adds a more personal touch. When patients complete their trial period, enter their birthdays in a file or excel sheet that you can easily refer to each month. This will help show patients that you care and keep them loyal to your practice. Read more…
 
Don’t Take a Vacation from Philanthropy. Give Today!
We hope you enjoy a little (or a lot!) of rest and relaxation this summer. With less hustle and bustle, now is the perfect time to make your Annual Fund gift to the AAA Foundation. Donating online is quick and easy!
 
Contribute to the PAC Today!
Renew your Academy membership and renew your commitment to the Political Action Committee (PAC)! PAC contributions play a critical role in gaining access to members of Congress and garnering support for key legislation.  Make your  yearly contribution when you renew your membership online or visit our Web site for more information or to make your contribution today. Only Academy members can donate to the American Academy of Audiology Inc., PAC
 
American Board of Audiology Specialty Certification Exams in October
Demonstrate to colleagues, other health-care providers, patients, and employers that you have obtained a high-level of knowledge in the field of pediatric audiology or cochlear implants. Become a Certified Pediatric Audiologist and/or a Certified Cochlear Implants Audiologist. Apply today! The ABA is offering the Pediatric Audiology Specialty Certification Exam and the Cochlear Implant Specialty Certification Exam in Denver, CO, on October 13, 2012. Applications are due August 13, 2012. Read more…
 
Expanded Coverage for Oxford OAE Testing Policy
Since November 2011, Academy members have been experiencing problems with United Health Care’s (UHC) commercial policy (Oxford) and UHC’s Medicaid Community and State coverage policy, which restricts OAE testing services to children from birth to three years of age unless the billing professional uses certain diagnosis codes when testing older individuals. Following its December 2011 meeting with UHC’s medical director, the Academy continued its dialogue with the medical director and provided supporting documentation, including a list of additional recommended ICD-9 codes to be added to the medical policy. On June 15, 2012, the Academy’s efforts resulted in the medical director updating the restrictive Oxford OAE policy and improving the coverage for audiology in the following ways:
  • Extends the age for testing children with OAE for any reason to four years of age (instead of conventional audiometry);
  • Adds numerous new ICD-9 diagnosis codes, which the Academy submitted to UHC for consideration, to the list of medical necessary codes;
  • Adds expanded medical necessity criteria for the use of OAE in conjunction with patients older than four years old, including ototoxicity; and
  • Clarifies that 92587 and 92588 are for diagnostic purposes and not “screening” in their application.
The new OAE policy is effective July 1, 2012. The Academy is seeking additional information from the UHC medical director to confirm that this policy will also apply to UHC’s Medicaid OAE coverage in the states of NY, NJ, and KY. Review the new Oxford OAE policy here.
 
Physician Quality Reporting System (PQRS) Easy Reference Guideline
To encourage reporting on the four 2012 PQRS eligible measures for audiologists, the Academy has created an Easy Reference Guide to assist you with reporting on these four measures (referral for otologic evaluation for congenital or traumatic deformity of the ear; history of active drainage within the previous 90 days; history of sudden or rapidly progressive hearing loss; and acute or chronic dizziness).

In an easy-to-read table format, the applicable CPT, ICD-9 and modifier codes are listed for each measure, as required for reporting. For those who don’t report on eligible measures in 2013, a disincentive of -1.5% on Medicare claims will be retained by Medicare contractors, beginning in 2015. While the Academy is currently seeking clarification regarding this disincentive, the Academy continues to encourage all Part B audiologists to report on eligible measures sooner rather than later.
 
Medicare Claims Submission Rejections Due to the HIPAA 4010 to 5010 Transition
Effective June 29, Medicare Administrative Contractors (MAC) will reject claims received via HIPAA version 4010/A1, with a message specific to that MAC. Visit the CMS Web site for a detailed list of rejection error messages if you have any claims errors about the HIPAA version 4010 to HIPAA version 5010 transition. As noted in prior e-audiology newsletters, this transition is a requirement for the eventual transition to the ICD-10 code system, for which a date of compliance has not yet been established.
 
Medicare Revalidation—Have You Received Your Letter?
As a result of the changes in Medicare enrollment due to the 2010 Affordable Care Act, Medicare is requiring every enrolled provider to be revalidated by the Centers for Medicare and Medicaid Services (CMS). The request for revalidation will arrive in a colored envelope between now and March 2015. Click here to see if you have received the request for revalidation. If you do not revalidate your Provider Transaction Access Number (PTAN) within 60 days of receiving this letter, you will run the risk of having your PTAN deactivated, meaning that you may not provide or be reimbursed for services provided to Medicare beneficiaries.
 

…that according to CMS, medical necessity is not necessarily established with a physician’s order? Coverage and, therefore, payment for diagnostic tests is determined by the reason the tests were performed rather than by the diagnosis, the patient’s condition, or the simple presence of a physician’s order. Examples of appropriate reasons for ordering diagnostic tests that could be covered include, but are not limited to:

  • Evaluation of suspected change in hearing, tinnitus, or balance;
  • Evaluation of the cause of disorders of hearing, tinnitus, or balance;
  • Determination of the effect of medication, surgery, or other treatment;
  • Failure of a screening test (although the screening test is not covered);
  • Diagnostic analysis of cochlear or brainstem implant and programming; and
  • Audiology diagnostic tests before and periodically after implantation of auditory prosthetic devices.

Referrals for hearing tests for the purpose of fitting hearing aids are never a covered benefit under Medicare and should not be billed to Medicare, even with a physician’s order. Diagnostic hearing tests absent a physician order also are not covered by Medicare. Diagnostic hearing tests that meet the coverage criteria are a covered benefit under Medicare and, in these cases, the physician order should be dated prior to the date of service for both the claim form and the test results. For more information see Chapter 15, section 80.3 (audiology service), of the Medicare Benefit Policy Manual

 
 

Audiologist

RGB Group, Inc. San Diego, CA

Clinical Audiologist

Eastern Shore ENT & Allergy Associates, PA Salisbury, MD

Browse audiology jobs and post your resume for free at www.HEARCareers.org.

 

July 10
eAudiology Web Seminar—Coding and Reimbursement Series: Documentation How To's: If It's Not in the Chart, It Didn’t Happen

July 11
eAudiology Web Seminar—Socialize Your Practice to Success

July 26
eAudiology Web Seminar—Vestibular Grand Rounds

August 24
Call for Nominations: Academy Board of Directors

September 20–22
California Academy of Audiology 13th Annual Conference

September 27–28
Maryland Academy of Audiology 20th Annual Conference

 

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