Palmetto/J1MAC News

The following information has been received by ANCO.


****PALMETTO/J1MAC NEWS****
Timely Claims Filing Requirement: Important Information
Effective immediately, the Centers for Medicare & Medicaid Services (CMS)
would like to remind Medicare fee-for-service physicians, providers and
suppliers, who are submitting claims to Medicare for payment, all claims
for services furnished on or after January 1, 2010, must be filed with your
Medicare contractor no later than one calendar year (12 months) from the
date of service or Medicare will deny them. This is a result of the Patient
Protection and Affordable Care Act (PPACA).
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8C5UT62660?opendocument&utm_source=J1BL&utm_campaign=J1BLs


J1 Provider Contact Center (PCC) Training and Holiday Closure Schedule for
Fiscal Year 2011
The J1 PCC Training and Holiday Closure Schedule for Fiscal Year 2011 is
now available on our Web site.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8C5QKU5678?opendocument&utm_source=J1BL&utm_campaign=J1BLs


Skilled Nursing Facility and Nursing Facility Reporting of Physician
Consultation Services
If a physician or non-physician practitioner is furnishing that
practitioner’s first E/M service for a Medicare beneficiary in a SNF or NF
during the patient’s facility stay, even if that service is provided prior
to the federally mandated visit, the practitioner may bill the most
appropriate E/M code that reflects the services the practitioner furnished,
whether that code be an initial nursing facility care code or a subsequent
nursing facility care code if documentation and medical necessity do not
meet the requirements for billing an initial nursing facility care code.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8C5SMM5368?opendocument&utm_source=J1BL&utm_campaign=J1BLs


J1 PCC to Close in Observance of the Holidays
The J1 Provider Contact Center (PCC) will be closed in observance of the
Christmas holiday on Thursday, December 23, 2010, and Friday, December 24,
2010. The PCC will reopen on Monday, December 27, 2010, at 7 a.m. PT. The
PCC will also be closed on Friday, December 31, 2010, in observance of New
Year's Day and will reopen on Monday, January 3, 2011, at 7 a.m. PT. Please
share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/8C6KTX6101?opendocument


2011 Coding Update
The 2011 Coding Update contains a wealth of information that will be
helpful to your office. This publication includes information on 2011
additions, deletions and changes for HCPCS, CDT and CPT codes and
modifiers, proper use of modifiers and more.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8C8LMQ2367?opendocument&utm_source=J1BL&utm_campaign=J1BLs


Incorrect Adjustments Impacting Part B Providers in Northern California,
Southern California, Ohio and West Virginia
This article announces that Palmetto GBA recently completed adjustments for
claims that originally processed from September 2, 2008, to October 28,
2010, with HCPCS codes G0181 and G0182. These adjustments incorrectly
canceled the original payment. The adjustments will appear on remittance
advices dated December 14, 2010, through December 20, 2010. The adjusted
claims will have the remark code CO-151, which states: 'Payment adjusted
because the payer deems the information submitted does not support this
many/frequency of services'. Providers will also receive demand letters for
these adjusted claims. Providers are encouraged to review the information
and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8C8SVY1100?opendocument&utm_source=J1BL&utm_campaign=J1BLs


President Obama Signs the Medicare and Medicaid Extenders Act of 2010
On Wednesday, December 15, 2010, President Obama signed into law the
Medicare and Medicaid Extenders Act of 2010 (MMEA). This new law prevents a
scheduled payment cut for physicians who treat Medicare patients from
taking effect. The Centers for Medicare & Medicaid Services (CMS) is
pleased that this law has addressed key issues for beneficiaries and
providers, and we are actively engaged in implementing these changes.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8CBLM37813?opendocument&utm_source=J1BL&utm_campaign=J1BLs


Incorrect Adjustments Impacting Part B Providers in Northern California,
Southern California, Ohio and West Virginia
Palmetto GBA has identified a problem with adjustments to some claims for
Care Plan Oversight (HCPCS codes G0181 and G0182). This issue impacts Part
B providers in northern California, southern California, Ohio and West
Virginia only for claims processed from September 2, 2008, through October
28,2010. If you received an overpayment letter for these services issued
during this timef rame, you do not need to take any action. Palmetto GBA
will send corrected notices to all affected providers.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8CBMDT3161?opendocument&utm_source=J1BL&utm_campaign=J1BLs


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