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Industry News: NHIC

Drug Screen Testing
Thursday, September 01, 2011

The following information is provided as clarification on how to bill the Drug Screen Testing codes.

G0431 Drug screen, qualitative; multiple drug classes by high complexity test method (e.g. immunoassay, enzyme assay), per patient encounter Effective 01/01/2010

G0431 QW Effective 01/01/10-03/31/11

G0434 Drug screen, other than chromatographic; any number of drug classes, by CLIA waived test or moderate complexity test, per patient encounter Effective 01/01/2011

G0434 QW Effective 04/01/2011

NHIC, Corp. (J14) to Begin Charging for Duplicate Remittance Advice Requests
Thursday, September 01, 2011

In accordance with the CMS Internet Only Manual (IOM) Publication 100-04, Chapter 22, Medicare contractors are allowed to charge for generating and mailing duplicate remittance advice (both electronic and paper) to recoup cost when generated at the request of a provider or any entity working on behalf of the provider.

Based on this, effective September 1, 2011 NHIC will begin charging $25.00 for each Duplicate Remittance Advice Request.

NHIC Introduces The Provider Services Portal (PSP)
Tuesday, October 26, 2010

The Provider Services Portal (PSP) is a website tool that can be used by NHIC J14 MAC Part B Providers. This includes J14 Part B providers in the states of Massachusetts, Maine, New Hampshire, Vermont and Rhode Island. The PSP offers the J14 MAC Part B provider community an alternative to the IVR or Customer Service Toll Free line.

This tool offers the following information through lookup transactions and there is no charge to access the PSP:

• Beneficiary Eligibility
• Claim Status

Signature Requirements
Wednesday, March 31, 2010

NHIC would like to remind providers of the current Signature Requirements as stated in Chapter 3 (3.4.1.1 ) of the Program Integrity Manual:
Medicare requires a legible identifier for services provided/ordered. The method used shall be hand written or an electronic signature (stamp signatures are not acceptable) to sign an order or other medical record documentation for medical review purposes.

NOTED EXCEPTION: Facsimile of original written or electronic signatures are acceptable for the certifications of terminal illness for hospice.

NHIC - LMRPs pertinent to Cytogenetic Studies
Monday, February 08, 2010

National Heritage Insurance Company revised the Local Medical Review Policy pertinent to Cytogenetic Studies.

The CPT codes are: 88230, 88233, 88235, 88237, 88239, 88240, 88241, 88245, 88248, 88249, 88261, 88262, 88263, 88264, 88267, 88269, 88271, 88272, 88273, 88274, 88275, 88280, 88283, 88285, 88289, 88291 and 88299.

This change is effective 10/01/2003 and expands the truncated code 752.8 to 752.89

Quarterly Certs Review
Thursday, January 28, 2010

NHIC and CMS continue to focus identification of provider compliance errors on duplicate claim denials. NHIC denied 4.00% of submitted claims as duplicates during the month of May 2007.

NHIC Corp. JURISDICTION 14 A/B MAC

Tuesday, November 24, 2009

A Clerical Error Reopening request should be requested as a telephone reopening or written reopening.