Billing News Dec 2011



EHR Adopters Get More Time to Meet Meaningful Use Standards

  • December 29, 2011

Physicians and facilities will have more time to qualify for government incentives to achieve meaningful use of electronic health records (EHRs). Under the current requirements, eligible doctors and hospitals that begin participating in the Medicare EHR Incentive Program this year would have to meet new standards for the program in 2013. If they...

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TRICARE Evaluation of CMS’s Approved Laboratory Developed Tests Demonstration Project

  • December 29, 2011

This notice is to advise interested parties of a Military Health System (MHS) demonstration project entitled TRICARE Evaluation of CMS Approved Laboratory Developed Tests Demonstration Project. The demonstration project is intended to determine whether it is feasible for the Department of Defense (DoD) to review CMS approved laboratory developed...

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Multiple Procedure Payment Reduction (MPPR) on Certain Diagnostic Imaging Procedures effective 1/1/2012

  • December 29, 2011

The MPPR on diagnostic imaging applies when multiple services are furnished by the same physician to the same patient in the same session on the same day. Currently, the MPPR on diagnostic imaging services applies only to technical component (TC) services. As of January 1, 2012, CMS is expanding the MPPR by applying it to professional component...

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Claim Adjustment Reason Code (CARC), Remittance Advice Remark Code (RARC), Medicare Remit Easy Print (MREP), and PC Print Update

  • December 29, 2011

The following new Claim Adjustment Reason Codes were approved by the Code Committee in October, and must be implemented, if appropriate, by April 2, 2012. New Codes ñ CARC: CodeCurrent NarrativeEffective Date 238 Claim spans eligible and ineligible periods of coverage, this is the reduction for the ineligible period (use Group Code PR). 3...

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Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 18.0, Effective January 1, 2012

  • December 29, 2011

The latest package of CCI edits, Version 18.0, is effective January 1, 2012 and includes all previous versions and updates from January 1, 1996, to the present. It will be organized in the following two tables: • Column 1/Column 2 Correct Coding Edits, and • Mutually Exclusive Code (MEC) Edits. Modified Column 1 and Column 2 Code...

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Molecular Diagnostic (MolDx )Update

  • December 29, 2011

Palmetto is currently updating the MolDx program to reflect the following suggestions from the laboratory industry: • Test Registration: They are simplifying the Z-Code process to capture only critical basic, demographic and general test descriptions. Specific test elements will only be required as part of the tech assessment process. This...

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NMP22 Bladder Check Test for Monitoring Bladder Cancer - Revised

  • December 29, 2011

The NMP22 Bladder Check Test is used in the diagnosis and monitoring of bladder cancer. NAS will allow coverage and payment for this test when used to monitor bladder cancer between cystourethroscopy intervals. Effective for dates of service on or after January 1, 2012, use the following codes: • 86386 - Nuclear Matrix Protein 22(NMP22...

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Lawmakers Pass Legislation To Defer Physician Pay Cut for Two Months

  • December 29, 2011

In last-minute maneuverings, Congressional lawmakers Dec. 23 approved an amended version of payroll tax legislation that also would defer for two months a Medicare pay cut for physicians due to be implemented Jan. 1. House and Senate leaders reached an agreement on the measure Thursday, narrowly averting a 27.5 percent reduction in Medicare...

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