A nationwide outbreak of salmonella has infected 241 people in 42 states since the first report in 2009, according to the Centers for Disease Control and Prevention (CDC). These salmonella cases weren’t from eating raw or undercooked food, as you might expect. Rather, these infections have been associated with exposure to African dwarf frogs.
These water frogs may be found in pet and educational stores, fairs and carnivals, etc. The CDC has linked the initial outbreak to a single African dwarf frog breeding facility in Madena County, Calif., Blue Lobster Farms.
Although intervention steps have been taken, the CDC says reports of people contracting the illness continue. No deaths have been reported, but children under 5 years are at high risk, as are pregnant women and people with weakened immune systems.
The infection is generally classified as gastroenteritis (ICD-9-CM 003.0 Salmonella). Typical signs and symptoms include diarrhea, fever, and stomach cramps 12 to 72 hours after infection. The illness usually lasts four to seven days and most people recover without treatment; however, severe diarrhea may require an individual to be hospitalized. In rare cases, the bacteria might spread into a person’s blood stream and then to other body sites, requiring the person to be treated with antibiotics.
Prevention best practices include proper hand washing techniques and avoidance of these amphibious creatures.
Source: CDC report, July 20, 2011
August 31st, 2011
The Centers for Medicare & Medicaid Services (CMS) recently announced a proposal to cover screenings for a variety of sexually transmitted infections (STIs), as well as high intensity behavioral counseling (HIBC) to prevent STIs.
Specifically, CMS proposes the following coverage for laboratory tests approved by the U.S. Food and Drug Administration (FDA), when ordered by the primary care provider and performed by an eligible Medicare provider:
- Screening for chlamydia and gonorrhea for:
- Pregnant women who are 24 years old or younger when the diagnosis of pregnancy is known, with repeat screening during the third trimester if high-risk sexual behavior has occurred since the initial screening test
- Pregnant women who are at increased risk for STIs when the diagnosis of pregnancy is known, with repeat screening during the third trimester if high-risk sexual behavior has occurred since the initial screening test
- Annually for women at increased risk for STIs
- Screening for syphilis for:
- Pregnant women when the diagnosis of pregnancy is known, with repeat screening during the third trimester and at delivery if high-risk sexual behavior has occurred since the previous screening test
- Annually for men and women at increased risk for STIs
- Screening for hepatitis B for:
- Pregnant women at the first prenatal visit when the diagnosis of pregnancy is known, rescreening at time of delivery for those with new or continuing risk factors
CMS is also proposing to cover up to two, 20-to-30 minute, face-to-face counseling sessions annually for Medicare beneficiaries for HIBC to prevent STIs for all sexually active adolescents and for adults at increased risk for STIs, when referred by a primary care provider and provided by a Medicare eligible primary care provider in a primary care setting.
HIBC is defined as a program intended to promote sexual risk reduction or risk avoidance which includes each of these broad topics, allowing flexibility for appropriate patient-focused elements:
- Skills training
- Guidance on how to change sexual behavior
High/increased risk individual sexual behaviors include:
- Multiple sex partners
- Using barrier protection inconsistently
- Having sex under the influence of alcohol or drugs
- Having sex in exchange for money or drugs
- Age (24 years of age or younger and sexually active for women for chlamydia and gonorrhea)
- Having an STI within the past year
- IV drug use (for hepatitis B only)
- Men having sex with men (MSM) and engaged in high-risk sexual behavior, without regard to age
In addition to individual risk factors, community social factors (such as high prevalence of STIs in the community populations) should be considered in determining high or increased risk for chlamydia, gonorrhea, and syphilis, and for recommending HIBC.
In defending its proposal, CMS noted that despite advances in both prevention and treatment, STIs remain an important cause of morbidity, and that rates of STIs in the United States exceed those in all other industrialized countries. Direct medical costs associated with STIs in the states are estimated at $15 billion annually. CMS is requesting public comment prior to making a final determination.
The Centers for Medicare & Medicaid Services (CMS) has instructed contractors to revise their claims processing systems to allow HCPCS Level II codes identifying noncovered ambulance transportation and transportation-related services into their systems for adjudication. Although these codes (A0021-A0424 and A0998) remain noncovered, accepting these claims will allow providers and suppliers to obtain a Medicare denial so that they may then submit a claim for a patient with Medicare to his or her secondary insurance for coordination of benefits (COB) purposes.
Providers and suppliers should begin submitting ambulance transportation and transportation-related service claims beginning Jan. 1, 2012. Providers and suppliers billing for noncovered ambulance services for the purpose of a Medicare denial should append modifier GY to the appropriate HCPCS Level II code for the service.
Source: CMS Transmittal 942, Change Request (CR) 7489, issued Aug. 5, 2011
The U.S. Office of Management and Budget recently approved changes to the Medicare Provider-Supplier Enrollment Applications (CMS-855) to update them from the 2008 versions, as well as the new CMS-855O application form used for the sole purpose of enrolling to order and refer items and/or services to Medicare beneficiaries. The revised and new forms are now available on the CMS Provider-Supplier website.
Providers and suppliers enrolling for the sole purpose to order and refer are required to begin using the new CMS-855O form immediately. Providers and suppliers using the other CMS-855 forms to enroll in Medicare are encouraged to begin using the revised forms; although, they may continue to use the old forms through October 2011.
Source: Palmetto GBA
Providers who submit claims for monthly end stage renal disease (ESRD) services (e.g., CPT® codes 90951 through 90966) should be aware of how to complete the Days/Units and Dates of Service (DOS) fields, reminds jurisdiction 1 Part B Medicare administrative contractor Palmetto GBA.
- Enter ‘1’ for the month
- ANSI 5010 electronic claims: Loop 2400, Segment SV1 and Element 04 (03=UN)
- CMS 1500 claims: Item 24g
- Enter a span of dates within the month billed
- ANSI 5010 electronic claims: Enter the last DOS in Loop 2400, Segment DTP/472, Element 03
- CMS 1500 claims: Item 24a
Example: For services provided during August 2011 (Aug. 1 through Aug. 29), enter “08/29/11″ as the date and “1″ for the days/units.