What’s the Social Security Number Removal Initiative (SSNRI)?

What’s the Social Security Number Removal Initiative (SSNRI)?

The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, requires to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019. A new Medicare Beneficiary Identifier (MBI) will replace the SSN-based Health Insurance Claim Number (HICN) on the new Medicare cards for Medicare transactions like billing, eligibility status, and claim status. Refer CMS…

Will Medicare contractors accept the CPT consultation codes when Medicare is the secondary payer?

Will Medicare contractors accept the CPT consultation codes when Medicare is the secondary payer?

Medicare will also no longer recognize the CPT consultation codes for purposes of determining Medicare secondary payments (MSP). In MSP cases, providers must bill an appropriate E/M code for the E/M services previously reported and paid using the CPT consultation codes. If the primary payer for the service continues to recognize CPT consultation codes for…

What is the CPT code for MMSE (Mini Mental Status Exam)?

What is the CPT code for MMSE (Mini Mental Status Exam)?

The 1997 version of Medicare’s Documentation Guidelines for Evaluation and Management Services indicates that “brief assessment of mental status including: orientation to time, place and person; recent and remote memory; mood and affect (e.g., depression, anxiety, agitation)” as one of the exam elements for examination. The physician administration, interpretation and written report associated with the…

What is eRX Limiting Charge?

What is eRX Limiting Charge?

The Medicare Fee Schedule for the year 2013 will have an additional column ‘eRX Limiting Charge’ that denotes “Limiting charge reduced based on status as an unsuccessful e-prescriber per the Electronic Prescribing (eRx) Incentive Program.” Beginning on January 1, 2012, EPs who are not successful electronic prescribers are subject to a negative payment adjustment. Section…

Who is a fiscal agent?

Who is a fiscal agent?

A fiscal agent is a private contractor to the state, normally selected through a competitive procurement process, may operate the state’s MMIS (Medicaid Management Information System). A state MMIS fiscal agent contract status report is prepared quarterly from CMS central office following the input from regional offices. The report is usually prepared within 30 days after the…

What is the CPT code to be reported when physician directly admits a patient to Hospital from the Office?

What is the CPT code to be reported when physician directly admits a patient to Hospital from the Office?

If patient is directly admitted to the Hospital from Office only an Office visit should be reported but an Initial Inpatient Hospital visit (CPT 99221-99223) can also be reported on the day on which physician first sees the patient in the Hospital. The initial hospital visit procedure codes are used for the first time the…

What is HEDIS?

What is HEDIS?

HEDIS stands for Healthcare Effectiveness Data and Information Set. It is the most widely used set of performance measures in the managed care industry. HEDIS was developed, and is maintained, by the National Committee for Quality Assurance (NCQA). HEDIS has become more than a set of performance measures; it is part of an integrated system…

What are the three levels of Physician Supervision?

What are the three levels of Physician Supervision?

CMS recognizes three primary levels of physician supervision. In the context of outpatient diagnostic services, these are defined as: 1. General supervision: The procedure is furnished under the physician’s overall direction and control. The physician must order the diagnostic test and is responsible for training staff performing the tests, as well as maintaining the testing equipment….

What is the CPT code to be reported by the transferring physician when a neonate is transferred to critical care on the same day that initial intensive care services were performed?

What is the CPT code to be reported by the transferring physician when a neonate is transferred to critical care on the same day that initial intensive care services were performed?

According to CPT 2012 guidelines, when a neonate is transferred from intensive care (CPT 99477) to a lower-level care, the transferring physician should report subsequent hospital care (CPT 99231-99233). If the neonate or infant must be transferred to critical care on a day when initial or subsequent intensive care services have been performed, the transferring…

What is HOS?

What is HOS?

The Health Outcomes Survey (HOS) is a Centers for Medicare & Medicaid Services (CMS) survey that gathers meaningful health status data from people with Medicare. Like HEDIS and CAHPS, HOS is part of an integrated system for use in quality improvement activities and to establish accountability in managed care. All managed care plans with Medicare…