Saturday, November 27, 2010

ASH & Palmetto/J1MAC News

The following information has been received by ANCO.


****ASH NEWS****
The American Society of Hematology's (ASH) Practice Update was published and is available online at http://www.hematology.org/Practice/Practice-Updates/5997.aspx. This edition features:

• Senate Passes Legislation to Avert Medicare Payment Cuts; Urge Your Representative to Support Stopping the Scheduled 23% Medicare Physician Payment Cut

• Final 2011 Physician Fee Schedule Rule Includes Significant Cuts

• ASH Annual Meeting: Policy & Practice Events You Will Want to Attend


****PALMETTO/J1MAC NEWS****
December 2010 J1 A/B MAC Medicare Advisory
The December 2010 J1 A/B MAC Medicare Advisory is now available on the J1
Web site. Providers are encouraged to review the information and to share
with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8BGKUY1013?opendocument&utm_source=J1BL&utm_campaign=J1BLs


J1 PCC to Close for Training
The J1 Provider Contact Center (PCC) will be closed for training on Friday,
December 3, 2010, from 11 a.m. to 3 p.m. PT. The PCC will reopen on
Friday, December 3, 2010, at 3 p.m. PT. Please share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8BFVR90761?opendocument&utm_source=J1BL&utm_campaign=J1BLs


Online Provider Services (OPS) Claims Status Enhancements
Palmetto GBA has enhanced the claims status feature of Online Provider
Services (OPS). OPS now displays the processed date and check number, if
applicable, when returning claims status for a beneficiary. OPS is our
secure Web portal that allows providers to access information regarding
claim status, beneficiary eligibility, amount approved-to-pay, and to view
duplicate remittance notices. All providers that have an EDI Enrollment
Agreement on file may register to use this tool. If you haven’t already
registered, please consider doing so. Access the introductory article to
learn more: click on the “Introducing Online Provider Services” graphic on
the top of any of our main state Web pages. One important consideration:
only one Provider Administrator per EDI Enrollment Agreement/per PTAN
performs the registration process. The Provider Administrator can then
grant permission to additional users related to that PTAN. Billing services
and clearinghouses should contact their provider clients to gain access to
the system.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8BGSRZ1171?opendocument&utm_source=J1BL&utm_campaign=J1BLs


J1 Part B LCDs Revised
Multiple J1 Part B LCDs have been revised. To view these LCDs, go to the
'LCDs and NCDs' Web page under the Medical Policies section of the J1 Part
B Web site. Please be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8BFVB65821?opendocument&utm_source=J1BL&utm_campaign=J1BLs


Multiple Procedure Payment Reduction (MPPR) on the Technical Component (TC)
of Certain Diagnostic Imaging Procedures
This J1 A/B MAC MLN Matters article (CR 6993) announces that Medicare is
changing the multiple procedure payment reduction (MPPR) on the technical
component (TC) of certain diagnostic imaging procedures. You should make
sure that your billing staffs are aware of these changes.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8BGLDH4824?opendocument&utm_source=J1BL&utm_campaign=J1BLs


Thirteenth National Education Call on Medicare Fee-For-Service (FFS)
Implementation of HIPAA Version 5010 and D.0 Transactions
The Centers for Medicare & Medicaid Services (CMS) will host its 13th
national education call regarding Medicare FFS implementation of HIPAA
Version 5010 and D.0 transaction standards on December 8, 2010. This
session will focus on provider outreach and education activities and
transition specific testing protocols. Subject matter experts will review
Medicare FFS communications, outreach and education strategy, as well as
provide information to help the audience through the transition to
implementation. The presentation will be followed by a Q&A session.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8BHMS75816?opendocument&utm_source=J1BL&utm_campaign=J1BLs


Multiple Procedure Payment Reduction (MPPR) for Selected Therapy Services
This J1 A/B MLN Matters article (CR7050) announces that Medicare is
applying a new multiple procedure payment reduction (MPPR) to the practice
expense (PE) component of payment of select therapy services paid under the
MPFS. Providers are encouraged to review the information and to share with
their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8BGSDE5876?opendocument&utm_source=J1BL&utm_campaign=J1BLs


Online Provider Services (OPS) Claims Status Enhancements
Palmetto GBA has enhanced the claims status feature of Online Provider
Services (OPS). OPS now displays the processed date and check number, if
applicable, when returning claims status for a beneficiary. OPS is our
secure Web portal that allows providers to access information regarding
claim status, beneficiary eligibility, amount approved-to-pay and to view
duplicate remittance notices. All providers that have an EDI Enrollment
Agreement on file may register to use this tool. If you haven’t already
registered, please consider doing so. Access the introductory article to
learn more by selecting the 'Introducing Online Provider Services' graphic
on the top of any of our main contract home pages. Please Note: Only one
Provider Administrator per EDI Enrollment Agreement/per PTAN performs the
registration process. The Provider Administrator can then grant permission
to additional users related to that PTAN. Billing services and
clearinghouses should contact their provider clients to gain access to the
system.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/8BGSRZ1171?opendocument


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Tuesday, November 23, 2010

Palmetto/J1MAC News

The following information has been received by ANCO.


****PALMETTO/J1MAC NEWS****
2009 PQRI and eRx Incentive Program Feedback Reports
After beginning the release of the 2009 PQRI feedback reports, the Centers
for Medicare & Medicaid Services (CMS) temporarily halted production of the
files to investigate some conflicting field information in the reports. The
2009 PQRI and eRx Incentive Program feedback reports will soon be made
available on the PQRI portal. CMS anticipates that the Taxpayer
Identification Number (Tax ID Number or TIN) level reports, which include
the National Provider Identifier (NPI) level reports, will be available the
week of November 22, 2010, on the PQRI Portal. Individual NPI reports will
be made available shortly afterward.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8BBGD64145?opendocument&utm_source=J1BL&utm_campaign=J1BLs


PC-ACE Pro32 Training Modules
Palmetto GBA is pleased to announce the availability of new Web-based
PC-ACE Pro32 training modules for Part A and Part B providers. PC-ACE Pro32
is a complete, self-contained electronic processing system for health care
claims submission and management. This system does not integrate into
office systems, such as accounts receivable, inventory or billing. It
provides you with the ability to enter patient, claim and procedure file
information while creating summary reports of the claims you submit
electronically.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~857MGQ4785?opendocument&utm_source=J1BL&utm_campaign=J1BLs


November 25 through 26 Medicare Payments
Palmetto GBA will not issue Medicare payments on November 25 through 26
because of the Thanksgiving holiday. Payments will be issued as usual on
November 24 and will resume on November 29.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8BBQYG0836?opendocument&utm_source=J1BL&utm_campaign=J1BLs


Provider Education for Handling National Provider Identifier (NPI) Issues
Related to Deceased Providers Who Had an NPI
This J1 Part B MLN Matters article (CR6984) explains how claims should be
submitted by representatives of deceased providers who had obtained an NPI
prior to death. A claim submitted after May 23, 2007, for a deceased
provider who had an NPI will be rejected by Medicare because the provider’s
NPI was deactivated in the Medicare claims processing system due to the
provider’s death. When a deceased provider’s claim is rejected by a
Medicare Contractor because of the absence of an NPI, the claim submitter
is expected to contact the Medicare Contractor to discuss payment of the
claim and the provider’s death. Providers are encouraged to review the
information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8BATB38107?opendocument&utm_source=J1BL&utm_campaign=J1BLs


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Friday, November 19, 2010

ACCC, CMA & Palmetto/J1MAC News

The following information has been received by ANCO.


****ACCC NEWS****
The Association of Community Cancer Center's (ACCC) Connect was published and is available online at http://www.accc-cancer.org/mediaroom/newsletters/2010/ACCConnect-11-17-2010.html. ANCO is an Institutional Member of ACCC. This edition features:

• Update on Commission of Cancer Program Standards Revision

• Conference Call: November 19 to Discuss Final 2011 HOPPS Rule and Physician Fee Schedule.

• FDA Approves Eisai's Halaven Injection for Treatment of Metastatic Breast Cancer

• Heard on ACCC's ListServ: Staffing Guidlines

• New Certifications: Oncology and Women's Health EHR


****CMA NEWS****
The California Medical Association's (CMA) Alert was pubished and is available online at http://www.calphys.org/html/news.asp. This edition features:

• CMA Stops Proposed Medicare Geographic Payment Cuts

• CMA Launches Campaign to Stop Medicare Cuts

• Two CMA Physicians Elected to State Assembly

• Time To Declare Medicare Participation for 2011

• CMA Publishes Guide to Obtaining Federal Funding for EHRs

• Webinar: EHRs--Meaningful Use


****PALMETTO/J1MAC NEWS****
2010 E-Prescribing Incentive Program Measurement Code Reporting Update
All eligible professionals (EPs) are encouraged to follow the current 2010
E-Prescribing (eRx) incentive program requirements. EPs should check the
measure specifications at the beginning of each year because they may
change. The correct measurement code to bill in 2010 for calculations of
the 2010 eRx incentive payment is HCPCS code G8553. The 2009 eRx
measurement codes have been accepted for processing by the Medicare claims
systems. However, in October, a temporary change occurred that led to the
rejection of 2009 eRx codes. EPs cannot resubmit claims that may have been
rejected with the 2009 eRx measurement codes. Submissions reported using a
qualified registry or a qualified electronic health record will not be
affected by this situation.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8B5QF80168?opendocument


Time Limit Denials
The time limit for filing claims to Medicare has changed. The changes
apply to Medicare primary and secondary claims. Claims with dates of
service October 1, 2008 through December 31, 2009, must be filed no later
than December 31, 2010. Services performed on or after January 1, 2010,
must be filed within one year from the date of service. Please review your
billing records carefully to ensure that your claims are filed on time.
Review this article for more information.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~7RJJMU2314?opendocument


Important Timely Filing Requirement Information: Reminder
If you are a Medicare fee-for-service (FFS) physician, provider or supplier
submitting claims to Medicare for payment, this is very important
information you need to know. Effective immediately, any Medicare FFS claim
with a date of service on or after January 1, 2010, must be received by
your Medicare contractor no later than one calendar year (12 months) from
the claim’s date of service, or Medicare will deny the claim.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8B8HVB4453?opendocument


Implementation of ERRATA Version 5010 of Health Insurance Portability and
Accountability Act (HIPAA) Transactions and Updates in 837I, 837P and 835
Flat Files
This J1 A/B MAC MLN Matters (CR7202) alerts and updates providers about the
administrative simplification provisions of Health Insurance Portability
and Accountability Act (HIPAA) Regulations that the Secretary of the
Department of Health and Human Services (DHHS) is required to adopt
regarding standard electronic transactions and code sets. Currently, CMS is
in the process of implementing an ERRATA version of 5010 of the HIPAA
transactions as well as the updates to the 837I, 837P and 835 flat files.
Be sure that you will be compliant with this next HIPAA standard by January
1, 2012. Providers are encouraged to review the information and to share
with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8B8Q943537?opendocument


Implementation of the PWK (Paperwork) Segment for X12N Version 5010
This J1 A/B MAC MLN Matters article (CR7041a) was revised on November 12,
2010, to reflect a revised CR 7041 issued on November 10, 2010. The
effective and implementation dates have been changed. In addition, the CR
transmittal number, release date and the Web address for accessing CR 7041
were revised. All other information is the same. The article announces the
implementation of the PWK (paperwork) segment for X12N Version 5010. The
PWK segment provides the ‘linkage’ between electronic claims and additional
documentation which is needed for claims adjudication. Providers are
encouraged to review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~896S543018?opendocument


Outpatient Therapy Cap Values for CY 2011
This J1 A/B MAC MLN Matters article (CR7107) describes the Centers for
Medicare & Medicaid Services (CMS) policy for outpatient therapy caps for
Calendar Year (CY) 2011. Therapy caps for 2011 will be $1,870. The
exceptions process will continue unchanged for the time frame directed by
Congress. Providers are encouraged to review the information and to share
with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8B8Q420673?opendocument


2011 Medicare Part B Fee Schedule: Northern California
The Northern California 2011 Medicare Part B Fee Schedule is now available
and is effective for services performed on or after January 1, 2011. As you
know, Medicare payment rates under the Medicare Physician Fee Schedule
(MPFS) are set according to statutory criteria. The following 2011 MPFS
payment rates are reflective of the 2011 Physician Fee Schedule Final Rule
that was put on display at the Office of the Federal Register on November
2, 2010, and are based on current law which provides a negative update for
2011. However, the Centers for Medicare & Medicaid Services will quickly
work to update MPFS payment rates in the event Congress passes legislation
to prevent the negative update from going into effect on January 1, 2011.
We encourage physicians and other affected practitioners to consider the
possibility of this legislation as you evaluate decisions related to your
annual participation election. Please be on the alert for more information
about the 2011 physician update as it becomes available.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8B8PAG2626?opendocument


2009 Electronic Prescribing (eRx) Incentive Program: Payments
The Centers for Medicare & Medicaid Services (CMS) is pleased to announce
that incentive payments for the 2009 Electronic Prescribing (eRx) Incentive
Program were made to eligible professionals who met the criteria for
successful reporting. This article includes information about how to
identify eRx payments on your paper or electronic remittance advice.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8B8JHW8618?opendocument


Implementation of HIPAA Version 5010 & D.0 Transactions Call
The Centers for Medicare & Medicaid Services (CMS) will host its 12th
national education call regarding Medicare fee-for-service (FFS)
implementation of HIPAA Version 5010 and D.0 transaction standards on
Wednesday, November 17, focusing on Coordination of Benefits (COB). Subject
matter experts will review Medicare FFS specific changes, including those
arising from the adoption of the HIPAA 5010 Errata, as well as general
information to help the audience prepare for the transition. The
presentation will be followed by a Q&A session. The target audience for
this call includes vendors, clearinghouses and providers who will need to
make Medicare FFS specific changes in compliance with HIPAA version 5010
requirements.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8B9HRR3770?opendocument


Registration for ONC Personal Health Records Roundtable Now Open
Online registration is now open for the roundtable on 'Personal Health
Records - Understanding the Evolving Landscape.' This free day-long public
roundtable, hosted by the Office of the National Coordinator for Health
Information Technology (ONC), will be held on Friday, December 3, 2010, at
the FTC Conference Center in Washington, D.C. Register to attend in person
or via Webcast by visiting the Health IT Web site.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8B9HWY8427?opendocument


Partial Code Freeze Prior to ICD-10 Implementation
This special edition article (SE1033) addresses the ICD-9-CM Coordination &
Maintenance (C&M) Committee meeting held on September 15, 2010. In that
meeting, the committee had finalized the decision to implement a partial
freeze for ICD-9-CM, ICD-10-CM and ICD-10-PCS codes prior to implementation
of ICD-10 on October 1, 2013. Providers are encouraged to review the
information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8B8S664065?opendocument


November 17 Grandfathering Notification Deadline for DMEPOS Bidding Program
- Message From CMS
Once the Durable Medical Equipment, Prosthetics, Orthotics and Supplies
(DMEPOS) competitive bidding program becomes effective on January 1, 2011,
beneficiaries with Original Medicare who obtain competitively bid items in
competitive bidding areas (CBAs) must obtain these items from a contract
supplier for Medicare to pay, unless an exception applies. All non-contract
suppliers that furnish competitively bid rented durable medical equipment
(DME) or oxygen and oxygen equipment to beneficiaries in CBAs must decide
if they will elect to become grandfathered suppliers, notify beneficiaries
of their grandfathering decisions, and fulfill other requirements.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8BAFZU5742?opendocument


J1 PCC to Close in Observance of Thanksgiving Holiday
The J1 Provider Contact Center (PCC) will be closed in observance of the
Thanksgiving holiday on Thursday, November 25, 2010, and Friday, November
26, 2010. The PCC will reopen on Monday, November 29, 2010, at 7 a.m. PT.
Please share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8B9QQN4104?opendocument&utm_source=J1BL&utm_campaign=J1BLs


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Friday, November 12, 2010

Palmetto/J1MAC News

The following information has been received by ANCO.

****PALMETTO/J1MAC NEWS****
Medicare Remit Easy Print (MREP) Enhancement
This J1 A/B MAC MLN Matters article (CR7178) announces the following list
of enhancements to the Medicare Remit Easy Print (MREP): 1) The MREP Demo
function has been updated to reflect current functionalities; and 2) A
report can be run now for Medicare Secondary Payer (MSP) Claims to
distinguish the Medicare secondary payments from the primary payments.
Providers using the MREP software need to obtain the new version in January
and install it to begin benefiting from these enhancements. Providers are
encouraged to review the information and to share it with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8AZKQ52465?opendocument


The Comprehensive Error Rate Testing (CERT) Fact Sheet (PDF, 321 KB)
The updated CERT Fact Sheet is now available on the J1 Web sites. Review
these facts before you submit to reduce claim submission errors and more.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~7S7RXH5804?opendocument


J1 PCC to Close on November 11 for Veteran's Day
The J1 PCC will be closed on Thursday, November 11, 2010, in observance of
Veteran’s Day. The call center will reopen on Friday, November 12, 2010, at
7 a.m. PT. Please be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/8AWQNX5670?opendocument


Denials: Top Reasons and Procedures
Find denial reasons in plain language and tips for resolving them in the
Palmetto GBA Denial Resolution tool. Top denial reasons include services
for hospice patients; bundled services; Medicare is the secondary payer;
and bundled payment for pre- and post-operative visits.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~7RHRDT1707?opendocument


Medicare Improves Access to Preventive Services for 2011
The Centers for Medicare & Medicaid Services (CMS) issued a final rule with
comment period that will implement key provisions in the Affordable Care
Act of 2010. These provisions expand preventive services for Medicare
beneficiaries, improve payments for primary care services and promote
access to health care services in rural areas. The new policies will apply
to payments under the Medicare Physician Fee Schedule (MPFS) for services
furnished on or after January 1, 2011.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8AWFU81003?opendocument


2009 Physician Quality Reporting Initiative (PQRI) Incentive Payment Update
Incentive payments for the 2009 Physician Quality Reporting Initiative
(PQRI) will begin this fall for eligible professionals who met the criteria
for successful reporting. Carriers and Medicare Administrative Contractors
(MACs) have begun processing and distributing 2009 PQRI incentive payments
on October 25, 2010. Distribution of 2009 PQRI incentive payments is
scheduled to be completed by November 12, 2010. These incentive payments
are paid as a lump sum to the Taxpayer Identification Number (TIN) under
which the professional’s claims were submitted.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8AWHFL0213?opendocument


American Recovery and Reinvestment Act of 2009 Electronic Health Record
(EHR) Incentive Program: Healthcare Common Procedure Coding System (HCPCS)
Modifier for the EHR Incentive Program
This J1 Part B MLN Matters article (CR7035) announces that the Centers for
Medicare & Medicaid Services has developed a new Electronic Health Record
Health Professional Shortage Area Modifier AZ, which will allow eligible
professionals to report claims rendered in a dental HPSA when the ZIP code
does not fully fall within that dental HPSA. Providers are encouraged to
review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8B2NKZ4542?opendocument


Palmetto GBA 1099/B Notice Request Form
The Palmetto GBA 1099/B Notice Request Form is now available online. Please
review and complete the form before submission.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8B2Q328780?opendocument


J1 Part B LCDs Revised
Multiple J1 Part B LCDs have been revised. To view these LCDs, go to the
'LCDs and NCDs' Web page under the Medical Policies section of the J1 Part
B Web site. Please be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/8B2SH65375?opendocument


Specialty Code for Advanced Diagnostic Imaging Services
This J1 A/B MAC MLN Matters article (CR7175a) was revised on November 4,
2010, to remove unnecessary language that had inadvertently referred to the
specialty code as a ‘DMEPOS’ code. All other information is the same. This
article announces that, effective April 1, 2011, the Centers for Medicare &
Medicaid Services (CMS) will establish a new specialty code (specialty code
95) for Advanced Diagnostic Imaging (ADI) Accreditation. Providers are
encouraged to review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8AVQJ41352?opendocument


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Friday, November 5, 2010

ACCC, CMA, & Palmetto/J1MAC News

The following information has been received by ANCO.


****ACCC NEWS****
The Association of Community Cancer Center's (ACCC) Connect was published and is available online at http://www.accc-cancer.org/mediaroom/newsletters/2010/ACCConnect-11-3-2010.html. ANCO is an Institutional Member of ACCC. This edition features:

• CMS Issues Final 2011 HOPPS Rule and Physician Fee Schedule

• Updated Part B Drug Information Guide Available Online

• Take Our Short Survey: Risk Information and ESAs

• Heard on ACCC's ListServ: Infusion Center Staffing

• EHR Incentive Program: Certified Health IT Product List

• Drugs in the News

• November Supplement to Come: Clinical Update on Care in Indolent Lymphoma


****CMA NEWS****
The California Medical Association's (CMA) Alert was published and is available online at http://www.calphys.org/html/news.asp. This edition features:

• CMA House of Delegates Adopts ACO Principles

• Has Your Contracted Health Plan or IPA Stopped Paying Claims?

• Medicare Claims Will Not Be Paid If Ordering or Referring Provider is Not in PECOS by January 3, 2011

• CMS PQRI Payments in the Mail

• New Issue of CMA Practices Resources (CPR) Now Available


****PALMETTO/J1MAC NEWS****
ANSI v5010: CMS-1500 to ANSI 837 v5010 Crosswalk
This article is the third in a series regarding implementation of version
5010 as the new standard for all ANSI ASC X12N electronic transactions.
This article includes a crosswalk from the CMS-1500 claim form to the ANSI
837 v5010 electronic claim format.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8ANJA28028?opendocument


Definition of a 'New Patient' for E/M Services
A ‘new patient’ is a patient who has not received any professional
services, such as evaluation and management (E/M) service or other
face-to-face service (e.g., surgical procedure) from the physician or
physician group practice (same physician specialty) within the previous
three years.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~87MH756568?opendocument


Evaluation and Management (E/M) Coding Reminders
This article provides guidance and helpful reminders about submitting
Evaluation and Management services.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~855RZS5055?opendocument


Evaluation & Management (E/M) Coding Reminder: Group Practices
Physicians in the same group practice who are in the same specialty must
bill and be paid as though they were a single physician. If more than one
evaluation and management (face-to-face) service is provided on the same
day to the same patient by the same physician or more than one physician in
the same specialty in the same group, only one evaluation and management
service may be reported unless the evaluation and management services are
for unrelated problems. Instead of billing separately, the physicians
should select a level of service representative of the combined visits and
submit the appropriate code for that level. This article serves as an
important reminder of the long standing policy for physicians in a group
practice. Please be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~7RDS6S7664?opendocument


2010 - 2011 Seasonal Influenza (Flu) Resources for Health Care
Professionals
This special edition article (SE1031a) was revised on October 26, 2010, to
include references to MLN Matters® article MM7120 (Influenza Vaccine
Payment Allowances – Annual Update for 2010 – 2011 Season) and to a new
Web-Based Training Module available on Medicare preventive services. In
this article, the Centers for Medicare & Medicaid Services (CMS) reminds
health care professionals that Medicare Part B reimburses health care
providers for seasonal flu vaccines and their administration. Medicare
provides coverage of the seasonal flu vaccine without any out-of-pocket
costs to the Medicare patient. Providers are encouraged to review the
information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8A5NMV3805?opendocument


Annual Clotting Factor Furnishing Fee Update 2011
This J1 A/B MAC MLN Matters article (CR7168) announces that for calendar
year 2011, the clotting factor furnishing fee of $0.176 per unit is
included in the published payment limit for clotting factors. The fee will
be added to the payment for a clotting factor when no payment limit for the
clotting factor is published either on the Average Sales Price (ASP) or Not
Otherwise Classified (NOC) drug. Providers are encouraged to review the
information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8ATPJR8268?opendocument


Twelfth National Education Call on Medicare Fee-For-Service (FFS)
Implementation of HIPAA Version 5010 and D.0 Transactions
The Centers for Medicare & Medicaid Services (CMS) will host its twelfth
national education call regarding Medicare FFS’s implementation of HIPAA
Version 5010 and D.0 transaction standards on November 17, 2010. This
session will focus on the Coordination of Benefits (COB).
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8AVG7R7051?opendocument


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