1. Will WC insurances reimburse Fluoroscopy procedures when performed in ASC setting? Where could I find ASC billing guidelines for WC claims? Fluoroscopy procedures are considered to be a part of primary procedures are there would not be any separate payment. You could view http://www.dol.gov/owcp/regs/feeschedule/fee/fee09/fs09ASCPaymentPolicy.doc for more information. 2. Are there any age criteria for…
Chronic kidney disease (CKD), also referred to as chronic renal disease, is a progressive loss of renal function over a period of months or years. All individuals with a Glomerular filtration rate (GFR) less than 60 mL/min/1.73 m2 for 3 months are classified as having chronic kidney disease, irrespective of the presence or absence of…
Effective April 1, 2010, CMS has implemented changes for reporting and processing purchased service information for diagnostic service claims. If the name of the provider who provided the purchased service for a diagnostic test and / or if the charge amount is missing or incomplete then the claim would be rejected. The rejection messages ‘Required…
The below links gives you a quick reference on the CMS implementation / changes / revisions posted through Medicare Learning Network (MLN) and CMS Transmittals effective for the year 2010. Medicare contractors https://www.cms.gov/MedicareProviderSupEnroll/downloads/contact_list.pdf Emergency Update to the 2010 MPFSDB http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6796.pdf New Place of Service (POS) Code for Walk-in Retail Health Clinic http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6752.pdf 2010 Consultation services…
CLIA – Clinical Laboratory Improvement Amendments 1. What is CLIA?2. Why is CLIA Important?3. What are the Types of CLIA Certificates?4. How Does a Laboratory Enroll in the CLIA Program? A quick reference for the above queries are answered @ http://www.cms.hhs.gov/MLNProducts/downloads/CLIABrochure.pdf CLIA Application form for Certification can be downloaded @ http://www.cms.hhs.gov/cmsforms/downloads/cms116.pdf Current CLIA Regulations are found @ http://wwwn.cdc.gov/clia/regs/toc.aspx…
CMS has announced the CPT changes (Additions / Revised and Deletions) for the year 2010 that has been posted in http://www.cms.hhs.gov/OutpatientCodeEdit/Downloads/SumofDataChngsSpec-CMSReport.pdf 2010 Current Procedural Terminology would contain 298 newly added CPT codes with 178 revised codes and 7 newly added Modifiers. 130 CPT codes have been deleted for the year 2010. A brief update on…
CMS has added 7 new modifiers for the year 2010 that are effective from Jan 1, 2010. The list of new Modifiers are given below Modifier AI – ‘Principal physician of record’ to be used by the admitting or attending physician who oversees the patient’s care, as distinct from other physicians who may be furnishing specialty care….
DOS and POS: New rules have been created for DOS and POS if the physician performs only the Professional services (Professional Component). The date of service for the professional component should be the actual date of interpretation and the Place of service should be ’11’ if the interpretation is done in Office or in Physician Home…
National Correct Coding Initiative – NCCI Updates National Correct Coding Initiative is developed by CMS to promote correct coding techniques in order to eliminate incorrect coding leading to inappropriate payment. NCCI edits are pairs of CPT or HCPCS codes that normally should not be billed by the same physician for the same patient on the…
General Equivalence Mappings – GEMs is a tool to be used like a bi-directional translation dictionary that was developed by National Center for Health Statistics (NCHS), the Centers for Medicare and Medicaid Services (CMS), AHIMA, the American Hospital Association, and 3M Health Information Systems to assist with the conversion of International Classification of Diseases, 9th…
