Alert! This area is where we outline recent product enhancements and resolved issues to help you stay up to date with the changes happening in Fusion Enterprise: Clinic Controller.
Note: There may be times when the Version numbers are skipped. Any changes or additions in skipped versions are included in the publicly released one.
Please note: All clinics are automatically released to this update since this is a Critical Update for COCQ Modifier handling. To schedule an update to the latest Version, submit a request via the link below.
Release Notes 5.0.66
- Fixed compatibility issue with older versions of SQL Server
- 2022 ICD-10 codes added
- SMS campaign registration check
- COCQ Modifier handling for 2022
*COCQ Update (more info)
In the final rule released on November 2, 2021, CMS finalized their proposal that the de minimis rule is applied to each 15-minute unit of a service, rather than to all the units of service. CMS finalized their proposal that the de minimis rule is not applied when the OT/PT provides more than the midpoint of a 15-minute timed code, that is, 8 or more minutes, regardless of any minutes for the same service furnished by the OTA or PTA. Lastly, CMS finalized their proposal clarifying the two remaining unit scenarios, to allow one unit to be billed with a CO/CQ modifier and the other unit to be billed without the CO/CQ modifier when the OTA/PTA and the OT/PT each provide between 9 and 14 minutes, independent of one another, with a total time between 23 and 28 minutes.
This change from the 10% de minimus standard proposed in November of 2020 is significantly more beneficial to therapy practices. These changes to the de minimus standard have been adjusted in the parameters that have been added to all Flow Sheet functions (even your custom ones), to enable you to indicate how much PTA/OTA time was spent on each activity. This way, Fusion Enterprise can compute whether or not the de minimus standard has been exceeded and can add modifiers accordingly.
For Flowsheet Users
We have made this as easy as possible. As you noticed, in version 5.0 we added PTA/OTA Time to all of the functions that also have DCT. The latest update will now utilize this field to properly code the CO/CQ modifiers.
In the above example, you can see that 5 minutes of the 10 minutes of DCT (Direct Contact Time) was done by a PTA or OTA. This is NOT in addition to the DCT. DCT should always be to total Direct Contact Time.
This also applies to unit-based codes as well.
For Manual Charge Entry
For customers entering their charges manually, a charge validation rule is available that will add CO or CQ to a visit scheduled with a Treating Therapist whose User has a User Position of 'PTA' or 'OTA'.
User Positions are assigned under Administration | General Information | Users/Therapists | User Positions.
To create the 'PTA' or 'OTA' position, go to Administration | General Information | Users/Therapists | Titles.
NOTE - this validation rule will not compute times to see whether or not modifiers are needed. It should only be enabled if the PTA/OTA will be handling at least 10% of all treatment codes when the visit is scheduled with a PTA/OTA. Should you wish to take our strong recommendation to transition to utilizing the Flow Sheet and need guidance doing so, please email support at firstname.lastname@example.org to schedule a time to connect.
*Customers will need to update to 5.0.66 in order for this functionality to be enabled.