Effective Oct. 1, 2012, Medicare systems will expect to see on claims a new occurrence code for reporting the date a patient dies.
Providers and suppliers who bill fiscal intermediaries (FIs), regional home health intermediaries (RHHIs), or Part A/B Medicare administrative contractors (MACs) for services provided to Medicare beneficiaries should include occurrence code 55 and the date of death on claims when also including one of the following patient discharge status codes: 20 (expired), 40 (expired at home), 41 (expired in medical facility), 42 (expired – place unknown).
Source: MLN Matters article MM7792, issued April 27, 2012
May 11th, 2012
At long last, Medicare is giving physicians who specialize in sleep medicine a little recognition by giving them their own specialty code. The Centers for Medicare & Medicaid Services (CMS) makes new specialty code CØ official in transmittal 2462. The new code is effective April 1, 2012.
Sleep medicine doctors can self-designate their specialty on the Medicare enrollment application (CMS-855I) or Internet-based Provider Enrollment, Chain and Ownership System (PECOS) when they enroll in the Medicare program, or revalidate their enrollment.
Also in this transmittal, CMS establishes sports medicine code 23 for durable medical equipment Medicare administrative contractors (DME MACs) and ViPS Medicare System (VMS). This specialty code has already been established for Part A/B MACs, fiscal intermediaries (FIs), carriers, and regional home health intermediaries (RHHIs) and their respective shared system maintainers in transmittal 2098.
Specialty codes are used by CMS for programmatic and claims processing purposes.
The results of the sixth annual Medicare Contractor Provider Satisfaction Survey (MCPSS) indicate an overall satisfaction level providers have with their Medicare contractors’ performance, with nearly 73 percent stating they are either satisfied (54.48 percent) or very satisfied (18.02 percent). The survey, conducted by the Centers for Medicare & Medicaid Services (CMS), had a good response rate, as well. Out of the 30,000 Medicare fee-for-service (FFS) providers and suppliers across the country who were asked to participate in the survey, over 16,000 responded.
September 16th, 2011
The Centers for Medicare & Medicaid Services (CMS) instructed regional home health intermediaries (RHHIs), Jan. 21, to hold claims where the revenue codes for both portable and stationary oxygen equipment rentals appear on the same claim. A systems error is preventing these claims from being processed and paid correctly.
CMS has identified the systems error that occurs when both portable and stationary oxygen equipment are billed on the same home health claim, but RHHIs are instructed to hold affected claims until the change is implemented, July 5, 2011.
Affected HCPCS Level II codes include oxygen and related respiratory equipment codes E0431, E0433, E0434, E1392, and K0738.
See CMS Transmittal 839, Change Request (CR) 7169 for more details.
January 28th, 2011
Independent and provider-based home health agencies (HHAs) will soon need to be more diligent about certain information listed on claims when billing for services provided to Medicare beneficiaries. The Centers for Medicare & Medicaid Services (CMS) has instructed regional home health intermediaries (RHHIs) to implement expanded edits beginning Jan. 1, 2011.
September 10th, 2010