2009 Medicare Physician Fee Schedules Available
As of January 1, 2009 the Medicare Physician Fees rise 1.1 percent; the new conversion factor is $36.0666.
Remittance Advice Remark Code and Claim Adjustment Reason Code
The following changes to the RARC and CARC codes will be effective January 1, 2009: Remittance Advice Remark Code Changes #t122008table {margin-bottom:25px;border-bottom:1px solid #ececec;} #t122008table td {border-top:1px solid #ececec;padding:7px; border:1px solid #efefef;} Code Current Narrative Medicare Initiated...
New RAC Appointments on Hold Until February
The Recovery Audit Contractors (RAC) program has proven to be successful in returning dollars to the Medicare Trust Funds and identifying monies that need to be returned to providers. It has provided CMS with a new mechanism for detecting improper payments made in the past, and has also given CMS a valuable new tool for preventing future payments. Section 302 of the Tax Relief and Health...
HHS proposes modifications to HIPAA standards for electronic transactions
The updated version of the health care transactions standard would replace Version 4010/4010A1. The new version, Version 5010, includes structural, front matter, technical, and data content improvements. Because the updated versions are more specific in requiring the data that is needed, collected, and transmitted in a transaction, their adoption would reduce ambiguities. Version 5010 would...
National Heritage Insurance Corporation awarded the Jurisdiction 14 contract
CMS recently announced that NHIC has been awarded a contract of up to five years for the combined administration of Part A and Part B Medicare claims payment in Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont.
Lipid Testing Frequency Limits
This article is in response to errors noted in medical review related to coverage and frequency of Lipid Testing per National Coverage Determination (NCD) 190.23. Routine screening and prophylactic testing for lipid disorder is not covered by Medicare. While lipid screening may be medically appropriate, by statue Medicare does not pay for it. Lipid testing in asymptomatic individuals is...
KRAS Gene Mutation Testing
CIGNA Government Services will allow KRAS Gene Mutation Testing in the care of patients with metastatic colon cancer who are being considered for an Epidermal Growth Factor Receptor inhibitor as second line therapy effective October 1, 2008. Generally these are billed by the reference lab performing the test for Medicare beneficiaries. The allowed CPT codes are 83890, 83892(2), 83898,...
Hepatitis C Genotype Restriction Update
Effective for dates of service on or after December 1, 2008, CPT-4 code 87902 (infectious agent genotype analysis by nucleic acid [DNA or RNA]; hepatitis C virus) must be billed in conjunction with one of the following ICD-9-CM diagnosis codes: ICD-9-CM Code Description 070.41 Acute hepatitis C with hepatic coma 070...