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  • Counseling Visit
  • ABNs: What to Change, What to Leave Alone
  • Tie Your Urodynamic Codes to the Procedures



    Greenway’s PrimeSuite® Integrated Software Solution Provides OB/GYN Specific Functionality for 20 New OB/GYN Practice Clients.


    May 3, 2004, Carrollton, Ga. – Greenway Medical Technologies, Inc., a leading provider of organically integrated practice management and electronic medical records (EMR) software solutions for physician practices, today announced the addition of twenty (20) new OB/GYN practice clients.  These OB/GYN practices have successfully deployed and are using PrimeSuite, Greenway’s web browser-based, integrated, clinical, financial, and administrative software solution specifically designed for medical practices. 


    With the addition of these twenty (20) OB/GYN practices to Greenway’s client base, more than 40% of Greenway’s client base is represented by OB/GYN practices. Although Greenway’s solution addresses many different medical specialties, the OB/GYN medical specialty represents Greenway’s largest concentration of PrimeSuite users.  Greenway’s experience in the OB/GYN medical specialty and PrimeSuite’s specific OB/GYN functionality has facilitated its continued success in this marketplace.  Examples of some of PrimeSuite’s OB/GYN specific functionality include prenatal flowsheets and an extensive library of OB/GYN clinical templates.

    The twenty (20) new OB/GYN practice clients that are being announced today are: East Tennessee Women’s Heath Specialists in Knoxville, Tenn.; Women’s Health Professionals in Albany, Ga.; OB/GYN Associates in Dover, Del.; Gwinnett GYN in Snellville, Ga.; Dr. Brown OB/GYN in Fairhope, Ala.; Women’s Healthcare in Haverhill, Mass.; Women’s Health Center of Southern Oregon in Grants Pass, Ore.; OB/GYN South in Birmingham, Ala.; North Park OB/GYN in Chattanooga, Tenn.; Women’s Health Professionals OB/GYN in Huntsville, Ala.; Women’s Health Specialists in Yuma, Ariz.; South Shore OB/GYN in St. Joseph’s, Mich.; Omega OB/GYN in Dallas, Tx.; Maternal Gynerations in Lawrencville, Ga.; Ford OB/GYN in Ashland, Ky.; OB/GYN Consultants in Knoxville, Tenn.; Women’s Clinic in Jefferson City, Mo.; Women’s Medical Group in Upland, Calif.; Women’s Clinic in Hattiesburg Miss.; and Emerald Coast OB/GYN in Panama City, Fla.


    “Greenway’s PrimeSuite is an all-encompassing, easy to use solution for my practice, which has allowed for increased organization within the office,” said Jerry E. Sanders, MD of East Tennessee Women’s Health Specialists. “By providing us with a foundation of easy to use, OB/GYN-specific functionality along with tools for physician customization, our practice has been able to make the transition to electronic medical records in a short amount of time.”  Dr. Sanders added, “from a physician’s perspective, the customizability of the EMR, as well as its intuitive layout, allows me to electronically document each patient encounter without any interference to patient communications or without any slow down in my daily work load.”


    “Our practice has benefited tremendously from the implementation of the Greenway system,” said David Stroud, MD of Women’s Health Professionals OB/GYN. “Patient documentation is certainly more complete as a result of using the PrimeSuite system, and our coding is also more accurate.  Each clinical template has been designed to automatically contract or expand as required by the complexity of the patient visit, continued Dr. Stroud.  “As I complete documenting each patient visit, the Greenway system automatically recommends the appropriate diagnosis, procedure and E&M codes for billing purposes.  The billing codes are generated in compliance to the documentation detail and are also checked to identify any inconsistencies between diagnosis and procedure codes.”


    Greenway’s commitment to providing efficiency to our clients and better service to their patients is the reason we developed PrimeSuite,” said Tee Green, president and COO of Greenway.  “PrimeSuite provides physicians more time to better understand and meet their patients’ healthcare needs and less time dealing with massive volumes of paperwork.  We are helping medical professionals do what they need to do – spend quality time with their patients.”


    Greenway’s PrimeSuite allows practitioners the ability to automate every step of a patient visit, including scheduling appointments, posting patient reminders, reviewing patient medical history, completely documenting patient encounters, managing the billing cycle, and processing claims.  Adherence to industry standards and compliance regulations in accordance with the new HIPAA rules are elements incorporated into the software. The integrated system architecture consolidates front and back-office functions so that unnecessary, redundant data entry is avoided and the practice’s workflow is rendered more efficiently.  As a result, physicians using PrimeSuite benefit from a more efficient workflow, thereby allowing for enhanced levels of patient care.


    About Greenway Medical Technologies, Inc.

    Based in Carrollton, Ga., Greenway is the only established software and service provider of a web browser-based ambulatory software suite that includes integrated practice management, electronic medical record (EMR), and managed care functionality.  A group of more than seventy-five physicians and healthcare professionals joined forces with a group of technologists to develop a suite of integrated, physician-centric software solutions designed to meet the healthcare industry’s demand for dependable, HIPAA-era management software solutions.  This software and service solution, called PrimeSuite, enables physicians, practice managers, and other healthcare providers to better serve their patients, more efficiently manage their practices, and increase practice profitability cialis online. 


    As part of detailed evaluations, Microsoft and the American Academy of Family Physicians (AAFP) awarded Greenway® the highest overall rating among all practice management solutions evaluated, and the Massachusetts Medical Society (owner and publisher of the New England Journal of Medicine) has provided Greenway® its endorsement. 


    Greenway® is a software services company focused on delivering complete physicians’ practice automated solutions through partnerships and technologies from Microsoft (Nasdaq: MSFT), Dell Computers (Nasdaq: DELL), ADAM, Inc. (Nasdaq: ADAM), and AT&T (NYSE: T).  For more information about Greenway®, call (800) 341-6313 or visit


    For More Information, Contact:

    Erin Barrett or Michael Jordan, For Greenway Medical Technologies, Inc., (843) 916-2000

    Bill Anderson, Greenway Medical Technologies, Inc. , (770) 836-3100 ext. 333




    May 5, 2004, 11:32

    Counseling Visit


    Question: How should I bill for a pregnant patient who has been scheduled for her eight-week initial ob appointment but can’t wait to have some questions answered and wants to come in earlier for a consultation? Her pregnancy has been confirmed at home, and no initial visit or ob panel blood work would be done at the consultation.


    Kansas Subscriber


    Answer: Normally, carriers consider all counseling that is related to pregnancy included in the global ob service.


    If you are billing separately for this service, however, this would not be a “consultation” as defined by CPT because the patient is referring herself to the ob-gyn to have her questions answered. Therefore, you would be reporting an E/M code.


    If the patient saw the physician for this visit, you could report a new patient code (99201-99205) based on the time spent with her if the physician documents the duration of the counseling visit. If the patient is established to your practice, however, you should bill an established patient E/M visit (99211-99215).


    On the other hand, if the patient saw a nurse for this visit, you would be confined to using an established patient code. And unless the nurse is a certified nurse midwife or a nurse practitioner, you must use 99211 for the encounter.


    Similarly, selecting a diagnosis code may present further questions because the ob-gyn is seeing the patient to provide advice and counseling rather than antepartum care. You could try V65.40 (Counseling NOS) or V65.49 (Other specified counseling), but carriers generally don’t allow you to use these codes as the primary diagnosis. But if this is the only reason for the visit, you could use either code. In addition, if the ob-gyn discusses genetics with the patient, you might use V26.3 (Genetic counseling and testing) instead.

    May 5, 2004, 11:30

    ABNs: What to Change, What to Leave Alone


    Got an itch to make a switch on an ABN? Proceed with caution


    When it comes to manipulation of its general ABN (or ABN-G) form, Medicare is like a stern but understanding parent: unbending on certain issues, yet sensible enough to be flexible when the situation calls for a slight alteration.


    If you make a change to an area Medicare has deemed “off-limits,” the ABN will likely be defective.


    Follow These 5 Rules


    Each ABN-G also has some areas that the provider can -- and in some cases should -- customize. When you file an ABN:


    -- The header should be altered to include your practice’s logo (if it has one), practice name, address and telephone number.


    -- The type should all be in 12-point Arial or Arial Narrow font. Believe it or not, use of other fonts or point sizes can render an ABN defective.


    -- The “Items or Services” box should be expanded if the space provided is not adequate.


    -- The “Because” box should be expanded if the space provided is not adequate.            


    -- All captions on the ABN should be left alone. Don’t make any changes to Medicare’s text on the form; you can alter it only for space, not content.


    Warning: Always use caution when tinkering with an ABN. While Medicare allows ABN alteration, under no circumstances will it accept an ABN of more than one page. It’s OK to print an ABN on legal-size paper to give yourself more space, but make sure you’re submitting only a single sheet.


    Do not alter any area of the ABN form not mentioned in this article. Fill those areas out completely and do not change them for any reason -- unless your intention is to render the ABN useless. (For complete instructions on proper use of ABNs, visit the Web site

    May 5, 2004, 11:28

    Tie Your Urodynamic Codes to the Procedures


    With so many urodynamic study codes, linking them to the appropriate procedure is essential. Use this list to link the procedure with the proper code:


    Voiding pressure studies (51795, Voiding pressure studies [VP]; bladder voiding pressure, any technique; and 51797, … intra-abdominal voiding pressure [AP] [rectal, gastric, intraperitoneal]) evaluate different functions. Code 51795 refers to measuring the detrusor muscle’s ability to contract. Code 51797 refers to a procedure to compare intra-abdominal pressure to detrusor muscle function. Ob-gyns often use 51795 and 51726 to diagnose obstruction.


    The cystometrogram (51725, Simple cystometrogram [CMG] [e.g., spinal manometer]) indicates if the detrusor muscle is functioning properly. The test detects the bladder’s capacity and abnormal detrusor sphincter contractions.


    If the patient’s incontinence is stress-induced, the CMG results are within the normal range. You would use 51726 (Complex cystometrogram [e.g., calibrated electronic equipment]) when you have calibrated electronic equipment that performs simultaneous measurements of intra-abdominal, total bladder and true detrusor pressures.


    Ob-gyns use uroflowmetry procedures (51736, Simple uroflowmetry [UFR] [e.g., stop-watch flow rate, mechanical uroflowmeter]; and 51741, Complex uroflowmetry [e.g. calibrated electronic equipment]) to measure decreased flow. Decreased flow indicates a malfunctioning detrusor due to a cystocele (618.x), neurologic lesions, or other reasons. Increased flow shows a malfunctioning urethra, which can lead to stress incontinence or intrinsic sphincter dysfunction.


    Report urethral pressure studies (51772, Urethral pressure profile studies [UPP] [urethral closure pressure profile], any technique) only if the patient has an artificial urinary sphincter. Generally, payers do not reimburse for this test unless other urodynamic tests are inconclusive.


    A final diagnostic tool is stimulus-evoked response (51792, Stimulus-evoked response [e.g., measurement of bulbocavernosus reflex latency time]). During this procedure, the physician applies electric stimulation to the clitoris. A delayed or lack of response to the stimulation may indicate a neurologic lesion.

    May 5, 2004, 11:26

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