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    • September 1, 2009

    There has been an increase of CERT errors for missing or illegible identifier on the medical records submitted to the CERT contractors. This requirement is indicated in the CMS Internet Only Manual (IOM), Publication 100-08, Chapter 3, Subsection 3.4.1.1.B which notes Medicare contractors require a legible identifier for services provided/ordered... more

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    • August 1, 2009

    National Government Services recent review of data identified that providers are billing inappropriately for CPTcode 80061, Lipid Panel and CPT 83721, Lipoprotein, direct measurement; LDL cholesterol on the same date of service. CPT code 83721 was often billed with CPT code 80061 on the same day with modifier -59 and the patient's... more

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    • June 1, 2009

    Recent data trends reveal an increasing number of physicians and facilities performing routine MRSA screening tests on patients using CPT code 87641: assays that detect methicillin resistance and identify Staphylococcus aureus using a single nucleic acid sequence. Medicare has a comprehensive list of screening tests that may be covered under... more

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    • November 30, 2015

    Effective for claims received 1/1/2016 with dates of service 10/1/2015 and after, claims submitted with a combination of non-covered routine diagnosis codes and payable diagnosis codes will be considered for payment. Providers that submit claims with the intent of denial for supplemental insurance will no longer be able to submit a routine... more

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