Primary Care Coding Alert
Capture HPSA Bonus With Exact Visit Location
Question: Our practice is in a rural area, but we don't always receive an HPSA bonus when our physician treats patients in their own homes. Is there any way to secure this reimbursement? Answers to You Be the Coder and Reader Questions by Barbara J. Cobuzzi, MBA, CPC, CPC-H, CHBME, president of CRN Healthcare Solutions in Tinton Falls, N.J.; and Victoria S. Jackson, practice management consultant with JCM Inc. in California.
Arkansas Subscriber
Answer: The Centers for Medicare & Medicaid Services recently clarified that Health Professional Shortage Area (HPSA) bonuses are in fact applicable for services provided in the patient's home.
However, you may encounter difficulty receiving this payment when the location of the service differs from the address that the beneficiary has on file with Medicare.
Why this would happen: According to CMS, the carrier sometimes has a -representative payee address- or mailing address that doesn't reflect the patient's true location. In such cases, the address on file may not reflect eligibility for an HPSA bonus.
Solution: CMS has now ordered carriers to investigate the exact location of service for HPSA claims with a -home- place of service (POS 12). You can also expect that CMS will soon ask you to assist the carriers and document the exact location where your physician provides service for POS 12 claims.
Primary Care Coding Alert
- Make 3 Changes to Your Nebulizer Coding And Slash Your Denials
Key: Incorporate the HCPCS Codes 2006 DuoNeb supply code You can keep [...] - You Be the Coder:
Avoid Biopsy Terminology Trip-Ups
Question: How should I code for an -excisional biopsy-? The family physician performed this procedure [...] - Learn 6 Must-Know Principles Of Moderate Sedation Coding
CPT 2006 replaces 99141-99142 with provider-, age- and time-specific codes With recent CPT revisions, you [...] - Capture Diabetes Counseling Services With This Action Plan
Medicare will cover MNT and DSMT--but you must meet these requirements With the number of [...] - Identify These Characteristics to Differentiate Among 99143-99150
Clip and post your quick reference guide to moderate sedation coding You can easily [...] - Reader Questions:
Use Current State of Asthma to Assign 5th Digit
Question: When reporting an asthma diagnosis, do I need a fifth digit?
Virginia Subscriber
Answer: Yes, [...] - Reader Questions:
Append 52 for Minor Puncture Wounds
Question: A patient presented with a puncture wound in the palm of her hand after [...] - Reader Questions:
Capture HPSA Bonus With Exact Visit Location
Question: Our practice is in a rural area, but we don't always receive an HPSA [...]
