Inpatient Facility Coding & Compliance Alert

Reader Questions:

Check Whether Your State Has Used Its Section 1011 Funds

Question: We sent our Section 1011 payment request to Highmark Medical Services, but it was denied. What's going on? Answer: As of February 23, a total of 25 states had reached their maximum funding for Section 1011 payment requests for dates of service April 1, 2011 through June 30, 2011. Providers in these states should no longer submit requests for payments or enrollment, according to a CMS representative during a recent Hospital and Hospital Quality Open Door Forum call. The new Section 1011 Administrative Contractor is Novartis Solutions, which Diversified Service Options (a subsidiary of Blue Cross Blue Shield of Florida) acquired from Highmark in January. You can read the latest on Section 1011 – including the states that can no longer file for payments – by visiting www.novartis-solutions.inc and clicking the Section 1011 tab. "X" Won't Just Mark a Spot in ICD-10-PCS Question: I've read articles or heard [...]
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