EHBR, LLC - What's New

NEW- IV Infusion Education Workbook- It includes all detailed guidelines as well as examples, coding exercises and all new updates.

Order an electronic version of this workbook for $25.00 or a printed copy for $50.00.

Contact Erica Dowden @ ericafashionista@yahoo.com to place an order.

I provide individual, facility or group training. Contact me if you are interested.

HIV screening is covered under preventative benefits as of December 8,2009. Claims for these services can be submitted after April 5, 2010. Refer to Transmittal 1918- http://www.cms.hhs.gov/transmittals/downloads/R1918CP.pdf

130 – Healthcare Common Procedure Coding System (HCPCS) for HIV Screening Tests

(Rev.1918, Issued: 02-19-10, Effective: 12-08-09, Implementation: 07-06-10)

Effective for claims with dates of service on and after December 8, 2009, implemented April 5, 2010, the following HCPCS codes are to be billed for HIV screening:

• G0432- Infectious agent antigen detection by enzyme immunoassay (EIA) technique, qualitative or semi- quantitative, multiple-step method, HIV-1 or HIV-2, screening,

• G0433 - Infectious agent antigen detection by enzyme-linked immunosorbent assay (ELISA) technique, antibody, HIV-1 or HIV-2, screening, and,

• G0435 - Infectious agent antigen detection by rapid antibody test of oral mucosa transudate, HIV-1 or HIV-2, screening.

Medically Unlikely Edits (MUE) are changing effective April 1, 2010.

CMS published Transmittal 617, CR 6712 on January 8, 2010 outlining these changes. This change will require hospitals to check MUE values for services reported on the claim prior to filing the claim to Medicare. http://www.cms.hhs.gov/transmittals/downloads/R617OTN.pdf

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ABN changes are effective April

Billing for Services Related to Voluntary Uses of Advanced Beneficiary Notices of Noncoverage (ABNs) http://www.cms.hhs.gov/transmittals/downloads/R1894CP.pdf

Information from the transmittal: *EFFECTIVE DATE: April 1, 2010. *IMPLEMENTATION DATE: April 5, 2010

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CMS issues FAQ on Observation services:

1. Use of condition code 44

2. Drug administration and observation services provided during Observation.

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(Updated April 2010)

http://www.cms.gov/center/provider.asp
Timely Filing Requirements for Medicare Fee-For-Service Claims
On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act (PPACA), which amended the time period for filing Medicare fee-for-service (FFS) claims as one of many provisions aimed at curbing fraud, waste, and abuse in the Medicare program.
The time period for filing Medicare FFS claims is specified in Sections 1814(a), 1835(a)(1), and 1842(b)(3) of the Social Security Act and in the Code of Federal Regulations (CFR), 42 CFR Section 424.44. Section 6404 of the PPACA amended the timely filing requirements to reduce the maximum time period for submission of all Medicare FFS claims to one calendar year after the date of service.
Under the new law, claims for services furnished on or after January 1, 2010, must be filed within one calendar year after the date of service. In addition, Section 6404 mandates that claims for services furnished before January 1, 2010, must be filed no later than December 31, 2010. The following rules apply to claims with dates of service prior to January 1, 2010. Claims with dates of service before October 1, 2009, must follow the pre-PPACA timely filing rules. Claims with dates of service October 1, 2009, through December 31, 2009, must be submitted by December 31, 2010.
Section 6404 of the PPACA also permits the Secretary to make certain exceptions to the one-year filing deadline. At this time, no exceptions have been established. However, proposals for exceptions will be specified in future proposed rulemaking.
Please be on the alert for more information pertaining to the Patient Protection and Affordable Care Act.
Listserv Message sent: 04/01/10