February 2007 Practice Update (part one)

Hematology-Specific Quality Measures Approved by AMA and AQA
The American Medical Association Physician Consortium for Performance Improvement and the AQA recently approved the ASH hematology-specific quality measures. ASH will continue to work closely with the Centers for Medicare and Medicaid Services (CMS) on finalizing the measures so that they will be incorporated in the new Medicare Physician Quality Reporting Initiative (PQRI) – a "pay-for-reporting" program that will be implemented July 1, 2007.

Coding Issue: Monitoring Anticoagulation with Coumadin
The Florida Society of Clinical Oncology (FLASCO) and doctors from other states have recently alerted ASH to concerns regarding reimbursement for monitoring anticoagulation with Coumadin. Code 99363 is a new 2007 code for coagulation management for the first 90 days. It is assigned 2.10 RVUs in the facility (hospital) setting and 3.01 in the office setting. For each additional 90 days of coagulation management, the physician can bill Code 99364. For the hospital setting, 0.82 RVUs are assigned and for the office setting 1.05 RVUs are assigned. Medicare has decided not to pay for these codes as CMS considers these services to be "bundled" into the E/M services provided. ASH will take the following steps to address member concerns:

• Write to the CMS Administrator requesting Medicare to reconsider its position
• Attempt to place this issue on Practicing Physicians Advisory Council (PPAC) agenda
• Work with other medical societies affected
• Work with ASH members to develop model language to use with private payers in an attempt to reverse their position

ASH will keep you apprised of next steps. Please feel free to contact the ASH Government Relations and Practice Department with and any practice-related questions and/or concerns you have.

Just Released: Idiopathic Thrombocytopenic Purpura (ITP) Practice Improvement Module
Physicians who treat idiopathic thrombocytopenic purpura (ITP) now have a new tool to help them provide the best care for patients with this disease. This Web-based practice aid is the first non-malignant hematology Practice Improvement Module (PIM). ASH and the American Board of Internal Medicine (ABIM) have been working together on the development of PIMs. PIMs are web-based self-evaluation tools that guide board-certified physicians through chart abstractions and a practice system inventory to establish a robust multi-dimensional practice performance assessment for a chronic condition or preventive service. The interactive report guides physician reflection on detailed performance data, selecting areas for improvement, and creating an improvement plan with goals and strategies. More details on maintenance of certification and PIMs can be found on the ASH Web site.

ASH Advocacy Campaigns Online
Visit the ASH Advocacy Center to take action on hematology-related legislation. Current campaigns include: stem cell research, NIH funding, and Genetic Information Nondiscrimination legislation; all of which are based on Congressional consideration and ASH modifies as appropriate.

2007 Practice Forum
ASH had a successful 2006 Practice Forum focused on Pay-for-Performance. The Society has begun planning for the 2007 forum and encourages State Societies interested in joining the planning committee should contact Stephanie Kart by February 16. Potential topics include: implementing information technology as part of reimbursement models; care of indigent patients; new development of Part D drugs, transition to MACs; and state universal healthcare plans and how they can impact practice.