Billing News Jul 2011



Medicare Remit Easy Print (MREP) Version 3.1

  • July 29, 2011

CMS presents the Medicare Remit Easy Print (MREP) software to view and print the HIPAA compliant 835 for professional providers and suppliers. Changes included with the new version of MREP are: • The updated "Codes.ini" file is provided, and the MREP software has been updated to include the updated list of Claim Adjustment...

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CMS Proposes to Rescind Lab Requisition Signature Requirement

  • July 29, 2011

CMS is proposing to rescind a new requirement that the ordering physician or qualified non-physician practitioner (NPP) sign requisitions for all clinical diagnostic laboratory tests paid under the Clinical Laboratory Fee Schedule (CLFS). CMS states in the proposed rule: Upon review of the concerns that industry stakeholders raised after we...

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NCD Decision Memo for Prothrombin Time (PT):Addition of two ICD-9-CM diagnosis codes

  • July 29, 2011

CMS has determined that two ICD-9-CM diagnosis codes: 786.50, Chest pain, unspecified and 786.51, Precordial pain, flow from the existing narrative for conditions for which a prothrombin time (PT) test is reasonable and necessary. Consequently, CMS will add these two ICD-9-CM diagnosis codes to the list of "ICD-9-CM Codes Covered by the...

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CMS Proposes Policy, Payment Rate Changes for the Physician Fee Schedule in 2012

  • July 29, 2011

CMS issued a proposed rule that would update payment policies and rates for physicians and nonphysician practitioners (NPPs) for services paid under the Medicare Physician Fee Schedule (MPFS) in calendar year (CY) 2012. CMS is required to issue a proposed rule that reflects current law. Under current law, providers would face steep across-the-...

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Registration Now Open for the ICD-10 Implementation Strategies for Physicians National Provider Call

  • July 29, 2011

On August 3, 2011 CMS will host a National Provider Call on "ICD-10 Implementation Strategies for Physicians." CMS subject matter experts will discuss ways that physician offices can prepare for the change to ICD-10 for medical diagnosis and inpatient procedure coding. Agenda: • ICD-10 overview • Lab NCDs conversion process...

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Delayed Implementation of X12N Version 5010 Paperwork Segment

  • July 29, 2011

CMS is delaying the implementation of the PWK (paperwork) segment associated with the X12N Version 5010 837 Professional and Institutional electronic claim transaction originally scheduled for July and October 2011. This means Medicare billers will continue to submit additional documentation which is needed for claims adjudication following the...

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Notice of New Interest Rate for Medicare Overpayments and Underpayments: Fourth Notification for FY 2011

  • July 29, 2011

The Department of the Treasury has notified the Department of Health and Human Services that the private consumer rate has been changed to 11.5 percent effective July 18, 2011, for Medicare overpayments and underpayments.

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J1 Part B Medical Review Top Denial Reason Codes

  • July 29, 2011

The J1 Part B Medical Review top denial reason codes article is now available on the J1 Part B Web site. Top Laboratory Denial Reason Codes 1. Denial Code N102 - Lack of Response to Medical Record Request 2. Denial Code 50 - Payer deems the information submitted does not support medical necessity of services billed. 3. Denial Code N237 ñ...

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