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Claims: Multiple CPIDs: 5010 Noridian Medicare A and B Processing Delays
From February 14, 2011 at 12:00 PM to present, Noridian has experienced 5010 claims processing delays associated with: Receipt of claims to their datacenter. Generation of 277CA reports for all Medicare Trading Partners. The reports may take up to 43 hours to generate. The following payers are affected: CPID 1455 Alaska Medicare CPID 1456 Arizona Medicare CPID 5546 Arizona Medicare CPID 5581 Idaho Medicare CPID 3521 Minnesota Medicare CPID 5584 Montana Medicare CPID 7400 Montana Medicare CPID 1523 North Dakota Medicare CPID 2453 North Dakota Medicare CPID 1459 Oregon Medicare CPID 5515 Oregon Medicare CPID 2454 South Dakota Medicare CPID 5589 South Dakota Medicare CPID 1527 Utah Medicare CPID 2458 Utah Medicare CPID 1462 Washington Medicare CPID 5521 Washington and Alaska Medicare CPID 2466 Wyoming Medicare CPID 3583 Wyoming Medicare Please be aware of these processing delays. If you have any questions, please contact Client Services at 1-888-348-8457, option 2.
Medical Management Strategies
(1) Noridian Medicare: (DME Billing) Noridian Medicare has been experiencing major issues with processing 5010 claims since January 1st. Their 5010 system is experiencing intermittence outage. Noridan is working to fix the problem. You may experience delay in payment compensations. (2) Medicare Update on 2012Payments: a) Medicare has begun to release EOBs (Explanation of Benefits) for the beginning of January dates of service and releasing the 10 day hold. b) Medicare is still delaying their 5010 implementation until April 1, 2012. During this 90 day non enforcement period (1-1-3-31-12), Medicare will have the systematic capability to perform up or down version conversions of incoming claim formats (either converting these to the 5010 format when necessary for cross over claims (billing secondaries) and/or leaving them in the 4010 EDI format. What has been occurring is these transitions are not always perfect and has created its own set of issues as well. (3) Medicare and Blue Cross Medical Management Strategies has also noticed that with all the changes going on in the industry for Electronic Data Information going to the new version 5010, there have been a number of significant issues that have occurred for Medicare and Blue Cross payers particularly. Medicare has had a number of issues to deal with this January which included revamping fee schedules, processing claims from clearinghouses in the older version since they put a hold on converting to the 5010 until April 1st, applying deductibles, etc. as well as crossover issues. Although they’ve been trying to notice everyone of how these transitions have been dealt with, there are still a number of issues particularly with clearinghouses to Medicare as well as crossover claims. Clearinghouses are reporting acknowledgements of claims going to Medicare and Medicare then stating they never received the batches.
Noridian Medicare Now Covers Renessa(R) Treatment for Incontinenc… ( NEWARK Calif. Feb. 24 /
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Stop Using 96402 For Lupron Injections In Noridian Patients
Now you will no longer be able to use 96402 for the administration. In place of chemotherapy drug administration codes 96401- 96549, you should select a code from the 96360-96379 code series. New way: It seems like Noridian (MAC) will suggest the use of the injection code 96372 (Therapeutic, prophylactic, or diagnostic injection [specify substance or drug]; subcutaneous or intramuscular) in place of 96402 for GNRH analogues such as Lupron, Zoladex, and Trelstar.Here’s an instance: A patient steps into your office for a Lupron injection. The urologist makes a clinical assessment through his examination (level-two evaluation & management service) that the patient can continue to get further doses of Lupron. This assessment demands a separate charge. Earlier you would have gone for 99212-25 for the clinical assessment, 96402 for the Lupron administration and J9217 for the drug. For a Nordian patient, now you would report 99212-25, 96372, and J9217. For more on this and for other specialty-specific articles to assist your urology coding, stay tuned to a good medical coding resource like Coding Institute.
CMS admits RAC got it wrong
The RAC audits have been a big headache for providers. In some cases, the patient’s sleep test was no longer part of the Medicare common working file, which generally gets purged after five years. So it was up to providers to prove that the test was actually done, and that it was paid for by Medicare, which may or may not have been the case.
HHS Announces New Affordable Care Act Demonstration Project
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BehaveNet® Opinion: Firing All Patients With Medicare
When I announced on my favorite physician Web board that I had mailed discharge letters to five patients solely because they have Medicare my colleagues hailed me as their “hero.” I don’t feel like a hero. I opted out of Medicare years ago, but Medicare requires physicians who have opted out to write a letter reaffirming that status every two years. Last year I realized it might have been four years, so I dashed off a letter and waited. You can imagine my shock when, on February 10, 2012, I opened a letter from “Darla” (no signature or last name) dated August 4, 2011, but with no postmark on the envelope. Darla writes that my “affidavit does not meet CMS requirements.” (What affidavit?) She goes on in her 6th grade English: “Opt Out Affidavit was unable to be processed. We did not receive the requested information in a timely manner. A request for information was sent June 13, 2011 to apply for a Type 1 NPI number.” (If Darla intends to say Noridian, the Medicare administrator for my area, sent that information to me, I never received it, and I already have some type of NPI number.) Then she writes that I need to use my “Legal Name” when “filling out the information.” (How does one “fill out information?”) I called Noridian provider enrollment to investigate. “April” reminded me that treating these Medicare beneficiaries without opting out subjects me to prosecution. I don’t want to go to jail, although at least there I might have a right to free medical care. I sent discharge letters to 5 patients and asked my office manager to call them to warn them in advance. Now I am completing a Medicare DISenrollment form. In the future I will require all new patients to demonstrate that they do NOT have Medicare.
TUMT: Transurethral Microwave Thermotherapy (TUMT)
Noridianmedicare.com: “TUMT, an appropriate therapy for symptomatic benign prostatic hypertrophy (BPH), is a method of delivering microwave heating sufficient to destroy prostatic adenoma tissue without significant damage to surrounding tissue. The FDA has, on May 3, 1996, approved a device for delivering this microwave therapy. TUMT is another nonsurgical therapy for BPH, and is appropriate when the following indications are met. Indications: All of the following characteristics must be present. A. Bladder Outlet Obstruction (BOO) and Lower Urinary Tract Symptoms (LUTS) of significant degree to cause an American Urological Association Symptom Score above seven. A score from 0-7 reflects mild symptoms, from 8-19 moderate, and from 20-35 severe. A patient with mild symptoms may be treated with medicine or, appropriately, receive no treatment at all. A patient with moderate symptoms may be treated with medical or surgical procedures. Noridian leaves this decision to the physician and the patient. B. A peak urine flow rate of 15 milliliters per second or less on a voided volume of 125 milliliters or greater. Relative contraindications: A. Prostate cancer B. Neurogenic bladder C. Active urinary tract infection D. Active cystolithiasis E. Gross hematuria F. Urethral stricture G. Bladder neck contracture H. Acute prostatitis I. Cardiac pacemaker When present, active cystolithiasis or active infection should be treated prior to treatment with TUMT. When prostate cancer and urinary obstruction are both present, TUMT may be appropriate therapy for relief of the urinary obstruction. Absolute contraindication: The presence of a metallic hip replacement.”
7 Medicare Documentation Errors From Recent Chiropractic Audits
Hopefully, some of these “real life” examples will help you think about improving your own billing, coding and documentation – for Medicare and other payers as well. If you need more “hands on” assistance with these items, consider attending one of my upcoming SEMINARS where we spend the better part of the afternoon going over the specifics of good, defensible documentation. And, of course, for those of you who just can’t make the trip, despite it’s massive potential to help you maximize reimbursements and minimize your audit risk (yes, I am a little biased)…stay tuned for more articles in the future. I’m sure Medicare will continue to dig in and take a look at us – and I’ll be here to report the results to you!