- November 06, 2009
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Make a lunch date with Highmark Medicare Services!
Join us on November 18, 2009 at noon for a Lunch Time Teleconference on Appeals - Clerical Reopenings. We will review the Appeals Center, Reopenings and the Five Levels of an Appeal. The handout material is now available.
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Join us on November 09, 2009 at 1:00pm for a teleconference on Inpatient Psychiatric Facility (IPF) & Long Term Care Hospital (LTCH) Advanced Billing. We will review the Comprehensive Error Rate Testing (CERT) Program, Interrupted Stay Policy, Billing Requirements, Benefits Exhaust and Self Services Options. The handout material is now available.
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Join us on November 12, 2009 at 10:00am for a teleconference on Inpatient Returns and Admissions. We will discuss Inpatient Prospective Payment System (IPPS) Transfers, Same Day Transfers, Repeat Admissions, Leave of Absence (LOA), Interrupted Stay Policy, Skilled Nursing Facility (SNF) Readmissions, and the CERT Program. The handout material is now available.
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Attention: UR Committees, Compliance Professionals, Medical Records, Hospitalists, Physicians and Clinical Professional staff
Join us on November 11, 2009 at 10:00am for an informative teleconference on Medical Review of Acute Hospital Inpatient Prospective Payment System (IPPS). We will discuss medical necessity, OPPS inpatient only policy, admission categories, proper documentation, the observation policy and review case studies. . The handout material is now available.
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- November 05, 2009
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This is a comprehensive education program to discuss the changes for IRFs effective January 1, 2010. Highmark Medicare Services will not be repeating this training, therefore it is imperative that you have representation at this training.
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MSP claims that have been returned, regardless if submitted via DDE or EMC, must be re-billed with appropriate corrections via EMC. Neglecting to do so will result in your claim automatically returning when corrections are made via DDE. As a reminder as of October 5, 2009, MSP claims are no longer accepted when submitted via DDE.
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The purpose of this third H1N1 call is to discuss the Secretary of Health and Human Services invoking her waiver authority under Section 1135 of the Social Security Act.
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New PC-ACE Pro32 Version 2.16 - Upgrade Available via Internet Download - UPGRADE NOW!
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Sign-Up Today to Receive Upgrade Notifications from Highmark Medicare Services.
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November is American Diabetes Month. Twenty four million adults and children in the United States suffer from diabetes. Complications from diabetes can include increased risk of heart disease, blindness, glaucoma, nerve damage, and kidney damage. However, detection and treatment of diabetes may prevent or delay many of these complications. CMS has developed several educational products related to Medicare-covered diabetes-related services. Visit the Medicare Learning Network (MLN) for more information.
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- November 04, 2009
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Join us on November 11, 2009 at 1:00PM for a teleconference on Blood Glucose Monitoring in a Skilled Nursing Facility (SNF). We will review routine blood glucose monitoring, covered blood glucose, documentation and the Comprehensive Error Rate Testing (CERT) Program. The handout material is available.
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Join the Outreach and Education Department on November 16, 2009 for a combined Part A and B Ambulance Webinar. We will discuss the CERT Program, Ambulance Coding, Medical Necessity, Documentation, the Ambulance Fee Schedule and a Website Tour. The handout material and registration are now available. This webinar is being offered in audio broadcast which means you can listen to it on your computer.
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Join us on November 17, 2009 at 1:00 PM for a teleconference on Outpatient Rehabilitation Billing. We will discuss Comprehensive Error Rate Testing (CERT) Program, Billing and Coding, Therapy Caps and Self-Service Options. The handout material is available.
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Our new provider bulletin center provides convenient access to our current and archived Medicare bulletins, newsletters, MLN Matters articles, and more. You can now access this information center, and others, through our left navigation bar.
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The Part A newsletter for October 2009 is now available. This month's edition has articles on the following topics: Update on PCA Service-Wide Review for Sleep Disorders, Billing Observation Services; Electronic Billing (EDI) News and Coverage of Inpatient Rehabilitation Services along with our November Calendar of Events.
MLN Matters Articles from CMS
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- November 03, 2009
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Join us on November 10, 2009 at 10:00am for a teleconference on Outpatient Rehabilitation Documentation. We will review outpatient rehabilitation services provided in different institutional settings, rehabilitation reimbursement and documentation requirements. The handout material is now available.
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- November 02, 2009
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Join us on November 4, 2009 at 2:00 PM for an informative teleconference on Cardiac Rehabilitation. We will review cardiac rehabilitation coverage and coding. The handout material is now available.
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The November 2009 edition of Part A & Part B EDI e-News is now available.
MLN Matters Articles from CMS
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- October 29, 2009
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Join us on November 5, 2009 at 1:00 PM for an informative teleconference on the KX modifier. We will be discussing the origin of the KX modifier, appropriate use of the KX modifier, documentation for therapy services, and billing the KX modifier. The handout material is now available.
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Join us on November 3, 2009 at 1:00 PM for an informative teleconference on Overlapping Claims. We will review Outpatient Services Treated as Inpatient Services, Consolidated Billing, Interrupted Stays, Patient Status Codes, and Other Overlap Issues. The handout material is now available.
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- October 28, 2009
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The following J12 MAC Local Coverage Determinations (LCDs) which were posted for notice on September 11, 2009 are effective as of October 28, 2009.
- L27548 - Acute Care: Inpatient, Observation and Treatment Room Services
- L30256 - C-Reactive Protein Testing
- L30271 - Non Vascular Extremity Ultrasound
- L30314 - Proton Beam Therapy
- L30277 - Stereotactic Body Radiation Therapy (SBRT)
- L30273 - Vitamin D Assay Testing
- L27547 - Wound Care
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