Part B Insider (Multispecialty) Coding Alert
Practices Still Making Massive Errors Regarding Units of Service Billed, OIG Says
Plus: Don't hold your breath waiting for an answer from CMS' ESRD mailbox -- the service is closed in preparation for ESRD FAQs
According to the audit report, which the OIG released on Aug. 28, Trailblazer incorrectly overpaid $126,171 to providers for high-dollar services during the audit period. Providers who received the inappropriate payments did not, for the most part, return the money to Trailblazer.
Many of the errors were caused by providers who entered incorrect cancer drug unit amounts on their claim forms. To read the report, visit www.oig.hhs.gov/oas/reports/region3/30700017.pdf.
In other news ...
• If you've got ESRD questions, don't look to the CMS mailbox for answers.
After CMS released its ESRD Conditions for Coverage final rule, the agency decided to create a Final Rule Rollout Mailbox to collect inquiries about the initiative.
In response to the questions, CMS has created an ESRD "frequently asked questions" document that gives definitive answers to many of the inquiries it received. The bad news, however, is that CMS will no longer monitor the ESRD mailbox. CMS is still accepting feedback through its other channels, but its employees stopped checking the ESRD mailbox as of Sept. 1.
For more information on the ESRD rule, visit http://www.cms.hhs.gov/CFCsAndCoPs/13_ESRD.asp.
• Have you been wanting to give CMS a piece of your mind? Now's your chance.
CMS is holding a town hall meeting Sept. 22 to gather feedback on "relevant Fee-for-Service (FFS) Medicare policy and operational issues," the agency says.
The agency will make presentations on HIPAA standards, recovery audit contractors (RACs), and Medicare administrative contractor (MAC) transitions, it says.
More information, including how to sign up, is at www.cms.hhs.gov /center/provider.asp under the "Spotlights" section.
Part B Insider (Multispecialty) Coding Alert
- Documentation:
CMS: Physician Signature Not Required for Diagnostic Tests
New clarification trumps previous adviceIn an attempt to clear up confusion about who can request [...] - Speech-Language:
Private Practice SLPs, Say Hello to Medicare Provider Status
A lucky MIPPA provision gives SLPs the ticketIf you're a speech-language pathologist in private practice, [...] - Icd-9 Coding:
Master Diagnosis Coding in 3 Easy Steps
Hint: Medical necessity is not necessarily a top priority in selecting a codeIf your diagnosis coding [...] - Billing:
Easily Evaluate Your Billing Procedures With Internal Audits
Start with a baseline audit , then make changes before auditors come knocking Would you [...] - Reader Question:
TMJ Arthrography May Merit 70332
But keep your eye on the diagnoses to confirm accuracyQuestion: What are the differences among [...] - Split Professional, Technical Components Like A Pro
Purchasing power will change the rules for modifiers 26, TCReporting modifiers 26 (Pro-fessional component) and [...] - Physician Notes:
Practices Still Making Massive Errors Regarding Units of Service Billed, OIG Says
Plus: Don't hold your breath waiting for an answer from CMS' ESRD mailbox -- the service [...]
