{"id":118,"date":"2016-04-20T12:53:48","date_gmt":"2016-04-20T18:53:48","guid":{"rendered":"https:\/\/dsiohn098w.mpqhf.org\/blog\/?p=118"},"modified":"2017-03-28T10:29:14","modified_gmt":"2017-03-28T16:29:14","slug":"hts-quick-way-see-getting-penalized","status":"publish","type":"post","link":"https:\/\/dsiohn098w.mpqhf.org\/blog\/hts-quick-way-see-getting-penalized\/","title":{"rendered":"HTS – MU: A quick way to see if you are getting penalized"},"content":{"rendered":"

\"A-quick-way-to-see-if-you-are-getting-penalized-by-CMS\"<\/p>\n

MU: Is your organization receiving negative adjustments from the CMS Quality and MU programs?<\/h1>\n

April 20, 2016<\/h5>\n
Written by Patty Kosednar<\/h6>\n

You may want to review your Medicare payments for adjustment codes from CMS for the Medicare Part B charges to determine if your organization is affected.<\/p>\n

We recommend reading\u00a0CMS\u00a0How Do I Avoid the 2016 Medicare Quality Reporting Payment Adjustments?<\/a>\u00a0 You will learn about the 2016 negative or downward payment adjustments for Physician Quality Reporting System (PQRS), Medicare EHR Incentive program, and Value Based Payment Modifier (VM).<\/p>\n

How will you know if your claim was adjusted?\u00a0 See page 6 in\u00a0How Do I Avoid the 2016 Medicare Quality Reporting Payment Adjustments?<\/a><\/p>\n

A CARC, Claim adjustment Reason Code and remittance advice remark code (RARC) are code sets used to report payment adjustments on an EPs or groups practice’s Remittance Advice. \u00a0Both of these code sets are updated three times a year.<\/p>\n

The PQRS, EHR Incentive program and VM currently use CARC\u00a0237 – Legislated\/Regulatory penalty, to designate when a negative or downward payment adjustment will be applied.\u00a0 At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance advice Remark Code that is not an ALERT) in combination with the following RARC’s:<\/p>\n