Proper Use of Protocols
Noridian Administrative Services, LLC (NAS) has noticed an increase of incorrect coding for Complete Blood Count (CBC) and Urinalysis (UA) laboratory services.
Clearing up the Confusion on Copying Military ID Cards
Per Department of Defense (DoD), it is both allowable and advisable for providers to copy a beneficiary’s ID card to facilitate eligibility verification and for the purpose of rendering needed services.
Screening for the Human Immunodeficiency Virus (HIV) Infection: Posted proposed decision memo
CMS proposes to cover HIV screening with an FDA-approved enzyme immunoassay.
Reminders from the CERT Documentation Contractor
CDC is encouraging providers who have voluminous pages of medical records to submit medical records electronically. Also because of a recent scam, some providers are reluctant to send the requested medical records to the CDC which is causing an increase in non-responder CERT claim errors.
Claims Submitted for Items or Services Furnished to Medicare Beneficiaries in State or Local Custody under a Penal Authority and Examples of Application of Government Entity Exclusion
Special conditions that must be met in order for Medicare to make payment for services provided to individuals or groups who are in the custody of penal authorities or in the custody of a government agency under a penal statute or rule.
Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 15.3, Effective October 1, 2009
There are no updates/changes to the CCI edits in the October 1, 2009 release that impacts laboratories.
Claim Adjustment Reason Code (CARC), Remittance Advice Remark Code (RARC), and Medicare Remit Easy Print (MREP) Update
These updates are effective October 1, 2009.
HITECH Breach Notification Interim Final Rule
HHS issued regulations requiring health care providers, health plans, and other entities covered by the HIPAA to notify individuals when their health information is breached.
Expansion of the Current Scope of Editing for Ordering/Referring Providers for claims processed by Medicare Carriers and Part B Medicare Administrative Contractors (MACs)
This article was revised to provide further clarification of what will happen during Phase 1 and Phase 2 of implementing this change.
Implementation of Health Insurance Portability and Accountability Act of 1996 (HIPAA) version 5010 for Transaction 835 - Health Care Claim Payment/Advice
It provides business requirements for the Medicare Contractors so they can be ready to generate transaction 835 in version 5010 for testing with trading partners and in production for early adopters effective January 1, 2011.
Clearing up the Confusion of Social Security Numbers; Verifying Eligibility
The Dept.of Defense is removing SSNs from their ID cards in three phases.
Correction to Lab Procedure Codes Billed With Nonspecific ICD-9-CM Codes
Effective for dates of service on or after October 1, 2009, CPT codes 82040 and 82043 can be billed with modifier QW.
New 2010 Pathology and Laboratory CPT Codes
New and deleted CPT codes effective 1/1/2010
AAPC Releases ICD-10 Code Conversion Tool, Now Available to the General Public
This valuable tool allows users to convert (or “map”) ICD-9-CM codes to ICD-10-CM codes based on the GEM files published by CMS.
NHIC Corp. JURISDICTION 14 A/B MAC
Reminder on how to determine the difference between a Clerical Error Reopening and a Redetermination.
Physicians Affected by BCBS Data Breach
850,000 physicians urged to be on lookout for signs of identity theft.
West Region Benefit Lookup Tool Now Available
Will allow registered users to query whether a service is a covered benefit, requires an authorization or needs medical review.
Signature requirements clarification
increase in the number of CERT errors related to the lack of a legible signature in medical record documentation.
CERT Feedback Report Errors and Recommendations for Improvement
Nearly half of errors identified in CERT Feedback Report, were a result of a lack of documentation of medical necessity.
Documentation Signatures
Treating physician’s signature must be present in the documentation associated with all services submitted to Medicare.