Beginning January 1, 2020, the Centers for Medicare & Medicaid Services will require that Part D ePrescribing be conducted using solely the NCPDP SCRIPT Standard Version 2017071. As a result, developers of 2015 Edition certified Health IT Modules certified to the ePrescribing criterion adopted at 45 CFR 170.315(b)(3) are permitted to update their products to use the NCPDP SCRIPT Standard Version 2017071 to meet CMS’ Part D ePrescribing compliance requirements.
The re-certification extends authorization to use DEA EPCS Certificates for another two years and allows physicians to use their Smartphone to comply with the required 2-Factor Authentication. This eliminates the need to carry a separate FOB or Id Cards.
A copy of the report has been posted on the ADL Website: EMR Certifications.
Approved Certification Process: //www.deadiversion.usdoj.gov/ecomm/e_rx/thirdparty.htm
Verify Physicians DEA Registration: //apps.deadiversion.usdoj.gov/webforms/validateLogin.jsp
Enhanced ICD-10 Diagnosis Codes Accessibility
Medication and lab orders in ADL will now display the most commonly used ICD-10 codes, based on the type of order. Upon entering an order into the system, prescribers will be prompted to choose from a list of the most appropriate ICD-10 codes, based on the medication or lab that they are ordering. Users will then select one of the available options or will be able to enter a code of their choice. The system will also show which are the best codes to maximize reimbursement.
CMS has provided a beta version of the PDPM calculator for the MDS. The calculator has been integrated into the MDS and is being test for early release. The screen has been simplified to provide a easier view.
Preview of the MDS RAI screen:
ADL is enhancing its software in preparation for the Patient Driven Payment Module (PDPM). Our goal is to assist facility staff in classifying patients into the appropriate payment groups based on data driven clinical characteristics. PDPM is value based and rewards patient outcomes.
Effective October 01, 2019, each patient will be assigned a case mix classification that drives reimbursement. The primary diagnosis (Section I10020B on the MDS) will determine which of the 10 clinical categories the patient will be assigned. Once the clinical category and any comorbidities are taken into account, the patient will be categorized further based on 5 criteria: Nursing, Occupational Therapy, Physical Therapy, Speech Therapy, Non Therapy Ancillary (NTA). These 5 items are the basis of PDPM.
Things to Review with Staff |
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| 1 | Ensure staff is proficient in ICD-10 coding and that all codes are accounted for appropriately. ADL software will display appropriate Diagnosis codes throughout the EMR |
| 2 | Make sure relevant staff is familiar with Section GG of the MDS |
| 3 | Calculates a residents LACE score to predict the rate of readmission or death within 30 days of discharge |
| 4 | Make sure comorbidities are captured upon admission |
| 5 | Make sure HIV/AIDS codes are accurate for the increased rate adjustment |
| 6 | Reduce burden of multiple assessments – Scheduled MDS assessments will decrease from a minimum of 5 in 100 day stay to 1 completed at the beginning of care |
| 7 | MDS I8000 Active Diagnosis – Make sure to capture accurate and detailed medical diagnosis |
| 8 | PDPM scores will be accessible within various places in the EMR as reference |
Compliance Requirements |
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|---|---|
| 1 | MDS new category I10020B for Primary Diagnosis will determine clinical categories |
| 2 | Providers will be required to complete an IPA with an ARD by 10/07/2019 for all Medicare Part A residents (10/01/19 is Day 1 so schedule accordingly) |
| 3 | Each should discipline justify and support the level of service provided. ADL will alert user when assessments are due and ensure that proper ICD-10 codes are used based on conditions and orders |
| 4 | Re-certification tracker of all active ICD-10 codes will keep you in compliance |
For more information, reference the CMS official website here.