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Billing news
Modified: 9/2/2010
The Office of the National Coordinator for Health Information Technology has selected two companies as the first technology review bodies authorized to test and certify electronic health record systems. [PERL 201009-03]
Modified: 9/1/2010
Change request 7081 is a reminder for physicians of the quarterly updates to Correct Coding Initiative edits. The last quarterly release of the edit module was issued in July 2010. [MM7081]
Modified: 9/1/2010
Effective January 1, 2011, the Medicare claims processing systems will recognize physician specialty code 12 as osteopathic manipulative medicine (previously recognized as osteopathic manipulative therapy). [MM6890]
Modified: 8/30/2010
Change request 7064 announces the implementation of an end-stage renal disease (ESRD) bundled prospective payment system (PPS) effective January 1, 2011, which combines payments for composite rate and separately billable services into a single base rate. [MM7064]
Modified: 8/27/2010
This MLN Matters article has been issued in response to inquiries related to change request 6711 pertaining to the use of the modifier JW for discarded drugs and biologicals. First Coast Service Options, Inc. made the decision to not require the modifier. [MM7095]
Modified: 8/27/2010
Change request 6874 clarifies instructions for processing claims submitted by Medicare beneficiaries. Contractors will also provide education to the beneficiaries on how to submit complete claims, including all supporting documentation. [MM6874]
Modified: 8/27/2010
The purpose and intent of change request 7095 is to reiterate to providers that contractors have the option to require or not require the modifier. First Coast Service Options, Inc. made the decision to not require the modifier JW. [Publication 100-04, transmittal 758, change request 7095]
Modified: 8/25/2010
As part of the transition to a value-based purchasing program for services of physicians and certain other professionals, as well as other related provisions, the Centers for Medicare & Medicaid Services will host a listening session on September 24. [PERL 201008-36, PERL 201008-13]
Modified: 8/20/2010
The MLN Matters article was revised on August 18 to correct an error in the “What You Need to Know” section on page 1. The HCPCS code of A450 was corrected to show A4650. All other information remains the same. [MM6968]
Modified: 8/19/2010
Avoid reading false or misleading information. It’s important that you have a reliable resource to turn to for accurate information. The Centers for Medicare & Medicaid Services (CMS) is the federal agency establishing these incentive programs. [PERL 201008-31]
Modified: 8/19/2010
Claims containing CPT code 90662 with dates of service on and after December 23, 2009, and before October 1, 2010 will be placed on hold and released for processing after the implementation of the October 2010 integrated outpatient code editor software. [JSM 10389]
Modified: 8/16/2010
The Centers for Medicare & Medicaid Services has released MLN Matters special edition article SE1022 to outline CMS’ policies and timeframes concerning the retention of medical records. [PERL 201008-26]
Modified: 8/13/2010
For the latest news and information, visit the Centers for Medicare & Medicaid Services DMEPOS competitive bidding webpage and click on the “Latest News and Announcements” link on the left side of the page. [CR 6571]
Modified: 8/12/2010
Change request 7080 expands the Medicare fee-for-service (FFS) reimbursement instructions outlined in CR 6960 by listing the standards for dates of service used to determine the timely filing of claims. [PERL 201008-15, MM7080]
Modified: 8/12/2010
Register now for this question and answer session addressing the specifics of the Medicare and Medicaid EHR incentive programs. Registration will close at 1:30 p.m. ET on August 12. [PERL 201008-20, PERL 201008-07]
Modified: 8/11/2010
This special edition article provides guidance for physicians, suppliers, and providers on record retention timeframes. It is informational in nature and there are no additions or changes to current policies and procedures. [SE1022]
Modified: 8/10/2010
Comments must be received by Wednesday, August 11. A summary of all the comments received will be posted on CMS’ Measures Management System Web page about four weeks after the public comment period closes. [PERL 201008-16, PERL 201007-55]
Modified: 8/9/2010
This article was revised on August 4 to reflect revisions made to change request (CR) 7006. The CR release date and transmittal number were changed and the Web address for accessing CR 7006 was also changed. All other information is the same. [MM7006]
Modified: 8/9/2010
The MLN Matters article was revised on August 6 to reflect the revised change request, which was re-issued on August 5. The article revised to include regional home health intermediaries in the section listing provider types affected. [MM6978]
Modified: 8/9/2010
The Centers for Medicare & Medicaid Services (CMS) has issued this important notice for all Medicare providers. [JSM 10382]
Modified: 8/3/2010
To ensure consistency with version 5010, effective January 1, 2011, the exception for place of service (POS) home will no longer be valid. Remember, you cannot submit a CMS-1500 form with more than one POS. [MM6947]
Modified: 8/3/2010
Providers that submit claims to CIGNA Government Services, Highmark Medicare Services, National Government Services, NHIC, and Noridian Administrative Services will now transition to U.S. Bank on August 30 instead of August 2. [PERL 201007-61]
Modified: 7/30/2010
The Centers for Medicare & Medicaid Services has issued two tip sheets regarding electronic health records incentive programs for eligible professionals. [PERL 201007-52]
Modified: 7/29/2010
If you receive a remittance advice on a Medicare beneficiary who’s not your patient, you should destroy it and report it to your fiscal intermediary, carrier, or Medicare administrative contractor. [PERL 201007-48]
Modified: 7/29/2010
The MLN Matters article was revised on July 26 to include revised effective and implementation dates, CR release date, and other CR details. In addition, claim adjustment reason codes and remittance advice remark codes have been added, where appropriate. The Web address for accessing the audiology code list was also revised. [MM6447]
Modified: 7/27/2010
The Centers for Medicare & Medicaid Services revised this article on skilled nursing facility consolidated billing to include “ambulatory surgical centers” in the last sentence in the top paragraph of page 3. All other information remains the same. [SE0432]
Modified: 7/23/2010
This demonstration will test whether the use of decision support systems can improve quality of care and reduce unnecessary radiation exposure and utilization by promoting appropriate ordering of advanced imaging services. [PERL 201007-44]
Modified: 7/22/2010
This is a reminder to providers to read about information for reporting and payment for the appropriate delivery of alcohol and/or substance (other than tobacco) abuse structured assessment and brief intervention services. [PERL 201007-40]
Modified: 7/22/2010
The Centers for Medicare & Medicaid Services has issued two fact sheet regarding the electronic health records incentive program final rule. [PERL 201007-39]
Modified: 7/20/2010
The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would expand preventive services for Medicare beneficiaries, improve payments for primary care services, and promote access to health care services in rural areas. [PERL 201006-45]
Modified: 7/14/2010
This article was revised to change the implementation date to August 13, 2010. In addition, the change request (CR) release date, transmittal number, and the Web address for accessing CR 6912 were revised. All other information remains the same. [MM6912]
Modified: 7/14/2010
This final rule addresses the electronic health record standards for certification and the Medicare and Medicaid electronic health record incentive programs, including the definition of meaningful use. [PERL 201007-22]
Modified: 7/9/2010
This article informs Medicare providers about reporting and payment for the appropriate delivery of alcohol and/or substance (other than tobacco) abuse structured assessment and brief intervention (SBIRT) services. [SE1013]
Modified: 7/9/2010
This article refers to denials when Medicare is the secondary payer during the coordination period of 30 months required for beneficiaries that are eligible for Medicare due to an ESRD diagnosis.
Modified: 7/8/2010
The Centers for Medicare & Medicaid Services proposes to implement changes required by the Affordable Care Act of 2010 to reduce out-of-pocket cost for beneficiaries receiving services in hospital outpatient departments and ambulatory surgical centers. [PERL 201007-05]
Modified: 7/7/2010
This law includes a number of provisions designed to help physicians. Some of those changes are reflected in the notice of proposed rulemaking CMS-1503-P. CMS is accepting comments on the proposed rule until August 24, 2010. [PERL 201007-07, SE1023]
Modified: 7/6/2010
Modifications to the healthcare common procedure coding system (HCPCS) code set have been posted to the HCPCS Web page. [PERL 201007-03]
Modified: 6/24/2010
This information outlines the process for the 935 recoupment.
Modified: 5/5/2010
Comparative billing report (CBR) information is available to providers and suppliers by request. [CMS Pub 100-08, Medicare Program Integrity Manual, Chapter 3, Section 11.1.6]
Modified: 4/12/2010
Requirements for submission of Advance Beneficiary Notices.
Modified: 4/12/2010
Provider specialty page on CMS.gov
Modified: 9/1/2009
Completion of the Overpayment redetermination request for a Medicare Part B claim form and receipt in the appropriate mailbox is critical to correct processing of an overpayment redetermination request.
