Posts Tagged ‘Trailblazer’

Health care providers in Colorado, New Mexico, Oklahoma and Texas submitting claims to TrailBlazer Health Enterprises should be aware of revisions the jurisdiction 4 (J4) Part A and Part B Medicare Administrative Contractor (A/B MAC) made, Oct. 5, to two local coverage determinations (LCD).

The revisions were made in response to a recent addition to the list of HCPCS Level II codes payable by Medicare, as noted in the October 2009 quarterly update released Aug. 28 by the Centers for Medicare & Medicaid Services (CMS). Read more »

An Oct. 8 post on TrailBlazer Health Enterprises’ Web site notifies Parts A and B providers that HCPCS Level II code J3420 is no longer covered as a self-administered drug, as indicated on the Self-Administered Drug Exclusions list, effective for service dates on or after Oct. 12.

TriSpan Health Services — the Medicare Part A fiscal intermediary (FI) for Louisiana and Mississippi under subcontract with Blue Cross Blue Shield (BCBS) — is ending its Medicare fee-for-service program administration agreement effective Sept. 30. Read more »

Medicare Administrative Contractor (MAC) TrailBlazer recently announced an inadvertent coding error. ICD-9-CM diagnosis code 238.79 Other lymphatic and hematopoietic tissues, used to indicate B-cell lymphoproliferative disorders expressing the CD-20 antigen as a covered diagnosis for J9310 Injection, rituximab, 100 mg, should be replaced with ICD-9-CM diagnosis code 238.77 Post-Transplant Lymphoproliferative Disorder (PTLD).

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Trailblazer Health Enterprises, LLC posted on its Web site May 15 a notice of mass adjustments it needs to make to claims for 2009 inpatient (Part A) claims with Medicare Severity-DRG (MS-DRG) 956 Limb reattachment, hip & femur proc for multiple significant trauma paid under the special-pay method.

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