Industry News: Kansas

This article is based on CR 6787 which instructs the Medicare contractors to incorporate an additional Kansas payment locality in the Clinical Laboratory Fee Schedule (CLFS) into their system to ensure correct pricing for certain laboratory claims submitted with a “90” modifier for services performed in the Kansas payment localities.

Empire Medicare New York has updated LCD 84066 / Phosphatase, acid, prostatic effective 04/15/2005 to include the following ICD-9 Codes: 199.0, 199.1, 600.01, 600.10, 600.11, 600.21, 600.90, 600.91

Medicare Secondary Payer (MSP) is the term used by Medicare when it is not responsible for paying a claim first. When Medicare began on July 1, 1966, it was the primary payer for all beneficiaries, except for those who received benefits from the Federal Black Lung Program, Workers’ Compensation (WC), and those that receive all covered health care services through the Veterans Health Administration (VHA) program. Beginning in 1980, changes to Medicare laws increased the number of coverage and benefit programs that are primary to Medicare.

Recently, WPS Medicare began seeing a dramatic increase in the number of providers experiencing claim denials when the provider submits claims past the timely filing limit for submitting claims. Although WPS Medicare recognizes that many providers must submit claims after Medicare's timely filing limit due to circumstances beyond their control, WPS Medicare must deny any claim submitted after the time limit for filing the claim expires.