Billing News Tags: Mckesson Claimsxten™ Launches March 1 2012

In last-minute maneuverings, Congressional lawmakers Dec. 23 approved an amended version of payroll tax legislation that also would defer for two months a Medicare pay cut for physicians due to be implemented Jan. 1.
The MPPR on diagnostic imaging applies when multiple services are furnished by the same physician to the same patient in the same session on the same day. Currently, the MPPR on diagnostic imaging services applies only to technical component (TC) services.
The amount that must remain in controversy for ALJ hearing requests filed on or before December 31, 2011, is $130. This amount will remain the same for calendar year 2012.
The latest package of CCI edits, Version 18.0, is effective January 1, 2012 and includes all previous versions and updates from January 1, 1996, to the present. It will be organized in the following two tables: • Column 1/Column 2 Correct Coding Edits, and • Mutually Exclusive Code (MEC) Edits.
The 5010 versions of the institutional and professional claim implementation guides mandate that when claims use non-specific procedure codes a corresponding description of the service is now required.
The following new Claim Adjustment Reason Codes were approved by the Code Committee in October, and must be implemented, if appropriate, by April 2, 2012. New Codes ñ CARC:
CMS is anticipating Congressional action to avert the negative update for the 2012 Medicare Physician Fee Schedule. Therefore, CMS is extending the 2012 Annual Participation Enrollment Period through February 14, 2012. The enrollment period now runs November 14, 2011, through February 14, 2012.
Physicians and facilities will have more time to qualify for government incentives to achieve meaningful use of electronic health records (EHRs). Under the current requirements, eligible doctors and hospitals that begin participating in the Medicare EHR Incentive Program this year would have to meet new standards for the program in 2013.
The NMP22 Bladder Check Test is used in the diagnosis and monitoring of bladder cancer. NAS will allow coverage and payment for this test when used to monitor bladder cancer between cystourethroscopy intervals. Effective for dates of service on or after January 1, 2012, use the following codes:
This article is to remind providers who bill Medicare Part A services that effective for dates of service beginning January 1, 2012, a brief hold will be placed on all claims. The hold will take place during the first 15 days of January 2012.
Palmetto is currently updating the MolDx program to reflect the following suggestions from the laboratory industry: • Test Registration: They are simplifying the Z-Code process to capture only critical basic, demographic and general test descriptions. Specific test elements will only be required as part of the tech assessment process.
Effective for dates of service on or after January 1, 2012, reimbursement and documentation requirements for CT scans performed on the same date have been updated for Multiple (Different) Anatomic Sites, Same Anatomic Site(s)/Repeat CT and Different Anatomic Site(s) Same Date.
Effective retroactively for dates of service on or after June 1, 2011, modifier 90 (reference [outside] laboratory) is an allowed modifier for HCPCS code G0434 (drug screen, other than chromatographic; any number of classes, by CLIA waived test or moderate complexity test).
The 2012 updates to the CPT-4 and HCPCS Level II codes will become effective for Medicare on January 1, 2012. The Medi-Cal and Family PACT Programs have not yet adopted the 2012 CPT-4 and 2012 HCPCS updates.
Effective February 1, 2012, the Indiana Health Coverage Programs (IHCP) has linked CPT code 83516 ñ Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quali-tative or semiquantitative, multiple step method to revenue code 300 ñ Laboratory for dates of service on or after February 1, 2012.
Effective January 6, 2012, for dates of service on or after April 1, 2011, the Indiana Health Coverage Programs (IHCP) has linked CPT code 88112 ñ Cytopathology, selective cellular enhancement technique with interpretation to revenue codes 310 ñ Pathology Lab; 311 ñ Pathology/Cytology; and 319 ñ Pathology/Othe
This notice is to advise interested parties of a Military Health System (MHS) demonstration project entitled TRICARE Evaluation of CMS Approved Laboratory Developed Tests Demonstration Project.
In last-minute maneuverings, Congressional lawmakers Dec. 23 approved an amended version of payroll tax legislation that also would defer for two months a Medicare pay cut for physicians due to be implemented Jan. 1.
The MPPR on diagnostic imaging applies when multiple services are furnished by the same physician to the same patient in the same session on the same day. Currently, the MPPR on diagnostic imaging services applies only to technical component (TC) services.
The amount that must remain in controversy for ALJ hearing requests filed on or before December 31, 2011, is $130. This amount will remain the same for calendar year 2012.
The latest package of CCI edits, Version 18.0, is effective January 1, 2012 and includes all previous versions and updates from January 1, 1996, to the present. It will be organized in the following two tables: • Column 1/Column 2 Correct Coding Edits, and • Mutually Exclusive Code (MEC) Edits.
The 5010 versions of the institutional and professional claim implementation guides mandate that when claims use non-specific procedure codes a corresponding description of the service is now required.
The following new Claim Adjustment Reason Codes were approved by the Code Committee in October, and must be implemented, if appropriate, by April 2, 2012. New Codes ñ CARC:
CMS is anticipating Congressional action to avert the negative update for the 2012 Medicare Physician Fee Schedule. Therefore, CMS is extending the 2012 Annual Participation Enrollment Period through February 14, 2012. The enrollment period now runs November 14, 2011, through February 14, 2012.
The NMP22 Bladder Check Test is used in the diagnosis and monitoring of bladder cancer. NAS will allow coverage and payment for this test when used to monitor bladder cancer between cystourethroscopy intervals. Effective for dates of service on or after January 1, 2012, use the following codes:
This article is to remind providers who bill Medicare Part A services that effective for dates of service beginning January 1, 2012, a brief hold will be placed on all claims. The hold will take place during the first 15 days of January 2012.
Effective for dates of service on or after January 1, 2012, reimbursement and documentation requirements for CT scans performed on the same date have been updated for Multiple (Different) Anatomic Sites, Same Anatomic Site(s)/Repeat CT and Different Anatomic Site(s) Same Date.
Effective retroactively for dates of service on or after June 1, 2011, modifier 90 (reference [outside] laboratory) is an allowed modifier for HCPCS code G0434 (drug screen, other than chromatographic; any number of classes, by CLIA waived test or moderate complexity test).
Effective February 1, 2012, the Indiana Health Coverage Programs (IHCP) has linked CPT code 83516 ñ Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quali-tative or semiquantitative, multiple step method to revenue code 300 ñ Laboratory for dates of service on or after February 1, 2012.
Effective January 6, 2012, for dates of service on or after April 1, 2011, the Indiana Health Coverage Programs (IHCP) has linked CPT code 88112 ñ Cytopathology, selective cellular enhancement technique with interpretation to revenue codes 310 ñ Pathology Lab; 311 ñ Pathology/Cytology; and 319 ñ Pathology/Othe

Pages