National Heritage Insurance Company (NHIC) issued a notification update Oct. 14 to clarify its coding and utilization guidelines for certain male external catheters supplied to Medicare beneficiaries.
November 2nd, 2009
The U.S. Food and Drug Administration (FDA) approved, Oct. 19, the use of the seasonal influenza vaccine Fluarix for children ages 3 to 17 years. This vaccine, which contains inactivated (killed) influenza A and B viruses, was previously approved for use in adults, ages 18 years and older.
November 2nd, 2009
Recovery Audit Contractors (RAC) HealthDataInsights (HDI) and CGI Federal have added to their list of new issues eligible for review as per the Centers for Medicare & Medicaid Services (CMS).
The RAC program, mandated by the Tax Relief and Health Care Act of 2006, is being implemented in 2010 to detect and correct past improper Medicare payments.
Tip: Don’t wait until Jan. 1, 2010 to review these new issues and correct any problems your outpatient hospital or physician practice may uncover. Read more »
November 2nd, 2009
The U.S. Food and Drug Administration (FDA) announced Oct. 23, in response to a request from the U.S. Centers for Disease Control and Prevention (CDC), it has issued an emergency use authorization (EUA) for the investigational antiviral drug peramivir intravenous (IV) in certain adult and pediatric patients with confirmed or suspected 2009 H1N1 influenza infection who are admitted to a hospital.
November 2nd, 2009
Electronic data interchange (EDI) for claims submission is a great thing, but infallible? No. EDI relies on computers, and we all know how reliable computers can be. Let’s just say, the job of a medical biller isn’t done after she clicks the Submit button. To ensure claims are processed correctly and in a timely fashion you need to pay attention to your explanation of benefits (EOB) and communicate with your Medicare Administrative Contractor (MAC), but that’s not all.
November 2nd, 2009
If you’re confused about carrier rules for coding H1N1 vaccines, you’re not alone. Choosing H1N1 codes in regard to Medicare and private insurance guidelines, and when to use a modifier can leave you dumbfounded. To answer your H1N1 questions, here’s the low-down on Medicare policies vs. private insurer policies.
November 2nd, 2009
Cardiac computed tomography (CCT) professionals will see major changes in coding next year. CPT® 2010 adds four new Category I codes to report CCT and cardiac computed tomography angiography (CCTA) services and deletes four Category III codes.
In a statement posted on its Web site prior to the Oct. 30 release of the 2010 Outpatient Prospective Payment System (OPPS) final rule, the Society of Cardiovascular Computed Tomography (SCCT) said it did not foresee significant changes in payment for CCT/CCTA. They were singing another tune Nov. 2.
November 2nd, 2009
In a clinical policy bulletin (CPB), Aetna clarifies its stance on the use of medical maggots for bio-surgery.
Aetna revised its policy May 8 to state that (effective Aug. 17, 2001) it considers medical maggots medically necessary for the debridement of any of the following non-healing necrotic skin and soft tissue wounds:
November 2nd, 2009
The Centers for Medicare & Medicaid Services (CMS) began accepting bids for the Round One Rebid of the Medicare Competitive Bidding Program for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) on Oct. 21. Qualified DME suppliers in nine areas have until Dec. 21 to submit bids.
Registration to participate in the Round One Rebid is nearing an end. Suppliers that wish to submit bids must be registered by Nov. 4, 9 p.m. EST.
November 2nd, 2009
The annual update to the clotting factor furnishing fee is $0.170 per I.U. and is effective from Jan. 1, 2010 to Dec. 31, 2010. This fee is included in the published payment limit for HCPCS Level II clotting factor billing codes (J7189-J7195) and added to the payment for a clotting factor when no payment limit is published either on the Average Sales Price (ASP) Medicare Part B Drug Pricing File or the Not Otherwise Classified (NOC) Pricing File.
