Worried about compliance? Since WoundExpert powered by xfit is perfectly fitted for wound care, we don’t just generically monitor regulatory changes. Instead, we watch with a keen eye towards anything that affects your medical record and coding needs. Learn about the regulatory changes that Net Health stays ahead of to help keep clients in the know and support compliance needs.
MACRA: Supporting the MIPS Track
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), implemented in October 2016, is a Quality Payment Program for Medicare that replaced the Sustainable Growth Rate formula. MACRA offers two tracks: MIPS (Merit-Based Incentive Payment System) or APM (Alternative Payment Model). WoundExpert supports the MIPS track which is most applicable to the wound care market. Required participants who choose not to submit any 2018 data will receive a -5% (maximum penalty) payment adjustment in 2020.
Four components make up the MIPS model:
- Quality (formerly known as PQRS)
- Promoting Interoperability (formerly known as Advancing Care Information and Meaningful Use—to obtain WoundExpert certification information click here)
- Improvement Activities (a new category that rewards clinicians for care focused on care coordination, beneficiary engagement, and patient safety)
- Cost (replacing Value Based-Payment Modifier)
To learn more about:
- the MIPS track, click here to visit the CMS website or click here for a wound care specific article written by Cathy Thomas Hess BSN, RN, CWCN published in Advances in Skin and Wound Care.
- how WoundExpert powered by xfit specifically supports MIPS, contact us at firstname.lastname@example.org or 800-411-6281 Option 3.
- improving your clinical and operational workflows to support MIPS reporting, discover our Professional Services with Cathy Thomas Hess by contacting email@example.com or 800-411-6281 Option 3.
Not only do we keep up with the latest ICD standards, including updating the code changes each October, WoundExpert also has a tool to assist you in making coding selections. Through a partnership with VitalWareTM, iDocuMintTM powered by ICD SherpaTM is a selection tool in WoundExpert that allows the user to type in keywords that describe the patient’s condition. The tool then guides the user through other key concepts that may relate to that condition, which assists the provider in selecting the most appropriate diagnosis code. After the ICD-10-CM code is selected, VitalWareTM provides considerations for documentation concepts that may be required. This can be especially helpful for physicians who may only work in wound care part-time.
Accurate ICD-10-CM code selection by providers is required to meet medical necessity and carrier policy requirements, which are necessary to support reimbursement.
Documentation Coding Reconciliation Features
Physician Evaluation and Management (E&M) Tool
WoundExpert directly utilizes the provider’s documentation and aligns the E&M level based on the 1997 Documentation Guidelines for Evaluation and Management Services. This can be especially helpful with ensuring the provider’s documentation supports the appropriate E&M levels for coding and reimbursement.
The Joint Commission
The Joint Commission standards “focus on important patient, individual, or resident care and organization functions that are essential to providing safe, high quality care.”1 We understand that complying with The Joint Commission Standards is important to our clients. That’s why WoundExpert provides the tools and necessary documentation elements to comply with the requirements set forth by The Joint Commission.
Electronic Prescribing of Controlled Substances (EPCS)
Through a partnership with DrFirst’s EPCS GoldSM solution, WoundExpert follows the regulations set by the Drug Enforcement Administration to allow for practitioners to electronically write prescriptions for controlled substances. Connecticut, New York, Minnesota, and Maine (for opiates only) require the use of electronic prescribing for controlled substances (EPCS), and it is both legal and widely used in all states. Providers who already e-prescribe save time by using a single workflow for both controlled and non-controlled drug prescriptions. Click here for an interactive map of the current state of EPCS mandates across the country.
Monitoring of Final Rules/Laws (Federal Register)
Keeping track of additional programs like Outpatient Prospective Payment System (OPPS) and Medicare Physician Fee Schedule (MPFS) can feel overwhelming when you are also trying to treat patients and run an efficient wound clinic. We’ve got you in mind. Our Product Compliance Team works tirelessly to monitor these programs and provide updates to WoundExpert to help support your clinic’s compliance with existing and ever-changing regulatory requirements that affect your EMR.
Interested in learning more about WoundExpert powered by xfit and compliance? Click here to contact Net Health.
1 Facts about Joint Commission standards. (2016, March 25). Retrieved January 24, 2017, from www.jointcommission.org/facts_about_joint_commission_accreditation_standards/