Updated Daily! brought to you by PC SOLUTIONS / DMEFREE visit us at www.dmefree.com

Thursday, July 30, 2009

Three DMEPOS Message Reminders

The Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) competitive bidding program Round 1 Rebid is coming soon!!
 
Summer 2009
Ø  CMS announces bidding schedule/schedule of education events
Ø  CMS begins bidder education campaign
Ø  Bidder registration period to obtain user ID and passwords begins
 
Fall 2009
Ø  Bidding begins
 
If you are a supplier interested in bidding, prepare now - don't wait!
 
Ø  UPDATE YOUR NSC FILES:   DMEPOS supplier standard # 2 requires ALL suppliers to notify the National Supplier Clearinghouse (NSC) of any change to the information provided on the Medicare enrollment application (CMS-855S) within 30 days of the change.  DMEPOS suppliers should use the 3/09 version of the CMS-855S and should review and update:
• The list of products and services found in section 2.D;
• The Authorized Official(s) information in sections 6A and 15; and
• The correspondence address in section 2A2 of the CMS-855S. 
This is especially important for suppliers who will be involved in the Medicare DMEPOS Competitive Bidding Program. These suppliers must ensure the information listed on their supplier files is accurate to enable participation in this program.  Information and instructions on how to submit a change of information may be found on the NSC Web site (http://www.palmettogba.com/nsc) and by following this path: Supplier Enrollment/Change of Information/Change of Information Guide. 
 
Ø  GET LICENSED:  Suppliers submitting a bid for a product category in a competitive bidding area (CBA) must meet all DMEPOS state licensure requirements and other applicable state licensure requirements, if any, for that product category for every state in that CBA.  Prior to submitting a bid for a CBA and product category, the supplier must have a copy of the applicable state licenses on file with the NSC.  As part of the bid evaluation we will verify with the NSC that the supplier has on file a copy of all applicable required state license(s).
 
Ø  GET ACCREDITED:  CMS would like to remind DMEPOS suppliers that time is running out to obtain accreditation by the September 30, 2009 deadline or risk having their Medicare Part B billing privileges revoked on October 1, 2009.  Accreditation takes an average of 6 months to complete.  DMEPOS suppliers should contact a CMS deemed accreditation organization to obtain information about the accreditation process and the application process.  Suppliers must be accredited for a product category in order to submit a bid for that product category.  CMS cannot contract with suppliers that are not accredited by a CMS-approved accreditation organization. 
 
Further information on the DMEPOS accreditation requirements along with a list of the accreditation organizations and those professionals and other persons exempted from accreditation may be found at the CMS website:  http://www.cms.hhs.gov/MedicareProviderSupEnroll/01_Overview.asp .
 
Ø  GET BONDED:  CMS would like to remind DMEPOS suppliers that certain suppliers will need to obtain and submit a surety bond by the October 2, 2009 deadline or risk having their Medicare Part B billing privileges revoked.  Suppliers subject to the bonding requirement must be bonded in order to bid in the DMEPOS competitive bidding program.  A list of sureties from which a bond can be secured is found at the Department of the Treasury's "List of Certified (Surety Bond) Companies;" the web site is located at:
 
Visit the CMS website at http://www.cms.hhs.gov/DMEPOSCompetitiveBid/ for the latest information on the DMEPOS competitive bidding program.
 
------------------------------------------------------------------------------------------------------------------
 
DMEPOS Supplier Accreditation and Surety Bond Requirement Deadlines Coming In October
Suppliers May Choose to Voluntarily Terminate Enrollment If They Do Not Plan To Comply
 
Medicare suppliers of durable medical equipment, prosthetics, orthotics and supplies (DMEPOS), unless exempt, must be accredited and obtain a surety bond by October 1, 2009 and October 2, 2009, respectively. 
 
If you have made the decision not to obtain accreditation or a surety bond when required, you may want to voluntarily terminate your enrollment in the Medicare program before the implementation dates above.  You can voluntary terminate your enrollment with the Medicare program by completing the sections associated with voluntary termination on page 4 of the Medicare enrollment application (CMS-855S).  Once complete, you should sign, date and send the completed application to the National Supplier Clearinghouse (NSC).  By voluntarily terminating your Medicare enrollment, you will preserve your right to re-enroll in Medicare once you meet the requirements to participate in the Medicare program. 
 
If you do not comply with the accreditation and surety bond requirements and do not submit a voluntary termination, your Medicare billing privileges will be revoked.  A revocation will bar you from re-enrolling in Medicare for at least one year after the date of revocation. 
 
Suppliers who do not plan to stay enrolled in Medicare are strongly encouraged to notify their beneficiaries as soon as possible so the beneficiary can find another supplier.
 
 
 
Take Action Now to Prepare for the Medicare Durable Medical Equipment, Prosthetics, Orthotics,
and Supplies (DMEPOS) Competitive Bidding Program!
 
A Special Edition MLN Matters education article identifying steps suppliers should take in preparation for the DMEPOS Competitive Bidding Program to ensure successful bidder registration is available at http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0915.pdf.
 
The article highlights specific sections of the CMS-855S, Medicare Enrollment Application, where the accuracy of the Authorized Official information and correspondence mailing address are critical for successful bidder registration.  The Centers for Medicare & Medicaid Services (CMS) urges suppliers planning to bid in the 2009 bidding cycle to read this article and make sure their most recent CMS-855S submission is still current and accurate.
 
-----------------------------------------------------------------------------------------------------------------
Note:  If you have problems accessing any hyperlink in this message, please copy and paste the URL into your Internet browser. 
If you received this message as part of the All FFS Providers listserv, you are currently subscribed to one of eighteen Medicare Fee-For-Service provider listservs.  If you would like to be removed from all NIH listservs, please go to (https://list.nih.gov/LISTSERV_WEB/signoff.htm) to unsubscribe.  If you would like to unsubscribe from a specific provider listserv, please go to (https://list.nih.gov/cgi-bin/show_list_archives) to unsubscribe or to leave the appropriate listserv. Please DO NOT respond to this email. This email is a service of CMS and routed through an electronic mail server to communicate Medicare policy and operational changes and/or updates. Responses to this email are not routed to CMS personnel. Inquiries may be sent by going to (http://www.cms.hhs.gov/ContactCMS). Thank you.

National Plan and Provider Enumeration System (NPPES) - Secure, Maintain and Update Your information

 
NPPES - Secure, Maintain and Update Your information
This message is for health care providers, particularly physicians and other practitioners, who have obtained National Provider Identifiers (NPIs) and have records in the National Plan and Provider Enumeration System (NPPES).  The Centers for Medicare & Medicaid Services (CMS) recommends that each health care provider, including individual physicians and non-physician practitioners:
 
·        Secure and maintain their own NPPES account information (i.e., User ID, Password, and Secret Question/Answer) for safety and accessibility purposes.  Health care providers should maintain the confidentiality of their User ID, password, and Secret Question/Answer in order to protect their NPPES information from unauthorized access.   
 
  • Reset their NPPES passwords at least once a year.  See the NPPES Application Help page at https://nppes.cms.hhs.gov/NPPES/Help.do  and select the 'Reset Password Page' for applicable rules.  Those rules indicate the length, format, content and requirements of NPPES passwords.
 
  • Review their NPPES records in order to ensure that the information reflects current and correct information.  Covered health care providers are required to update their NPPES information within 30 days of the effective date of the change
 
 
Viewing NPPES Information
Health care providers, including physicians and non-physician practitioners, can view their NPPES information in one of two ways:
 
(1) By accessing the NPPES record at https://nppes.cms.hhs.gov/NPPES/Welcome.do and following the NPI hyperlink and selecting Login.  The user will be prompted to enter the User ID and password that he/she previously created. *
 
* If the health care provider has forgotten the password, enter the User ID and click the "Reset Forgotten Password" button to navigate to the Reset Password Page.  If the health care provider enters an incorrect User ID and Password combination three times, the User ID will be disabled.  Please contact the NPI Enumerator at 1-800-465-3203 if the account is disabled or if the health care provider has forgotten the User ID.
 
OR
 
(2) By accessing the NPI Registry at https://nppes.cms.hhs.gov/NPPES/NPIRegistryHome.do.  The NPI Registry gives the health care provider an online view of Freedom of Information Act (FOIA)-disclosable NPPES data.  The health care provider can search for its information using the name or NPI as the criterion.   Information regarding NPPES data that are FOIA-disclosable can be found at http://www.cms.hhs.gov/NationalProvIdentStand/ by selecting 'Data Dissemination'. 
 
Please note:  Business Mailing Address and Business Practice location information (full address and corresponding telephone numbers) are key data elements that are FOIA-disclosable.  Health care providers should not report their residential address unless it is their Business Mailing Address or Business Practice location.  The NPPES data appearing on the NPI Registry cannot be deleted; however, it can be updated or changed.
 
 
Updating NPPES Information
Health care providers, including physicians and non-physician practitioners, can correct, add, or delete information in their NPPES records by accessing their NPPES records at https://nppes.cms.hhs.gov/NPPES/Welcome.do and following the NPI hyperlink and selecting Login. The user will be prompted to enter the User ID and password that he/she previously created.  
 
Please note: Required information cannot be deleted from an NPPES record; however, required information can be changed/updated to ensure that NPPES captures the correct information.  Certain information is inaccessible via the web, thus requiring the change/update to be made via paper application.  The paper NPI Application/Update Form (CMS-10114) can be downloaded and printed at http://www.cms.hhs.gov/cmsforms/downloads/CMS10114.pdf.
 
Deactivating the NPI
Health care providers, including physicians and non-physician practitioners, can deactivate their NPIs if the NPIs are no longer required or needed.  Reasons for deactivation include retirement, business dissolved, or death of the health care provider.  A request for deactivation must be submitted via paper application.  The paper NPI Application/Update Form (CMS-10114) can be downloaded and printed at http://www.cms.hhs.gov/cmsforms/downloads/CMS10114.pdf.  Health care providers should review the instructions located on the application regarding deactivations in order to properly complete the deactivation request.  The Power of Attorney or Executor of the Will may complete the application for deactivation due to death of the health care provider.
 
*****
Physicians:  Did your academic medical institution or medical school university obtain your NPI for you?  If so, please be sure to read an upcoming special listserv message on this topic.
 
*****
Need More Information?
 
Visit CMS' dedicated NPI web page at www.cms.hhs.gov/NationalProvIdentStand for additional NPI information.
-----------------------------------------------------------------------------------------------------------------
Note:  If you have problems accessing any hyperlink in this message, please copy and paste the URL into your Internet browser. 
If you received this message as part of the All FFS Providers listserv, you are currently subscribed to one of eighteen Medicare Fee-For-Service provider listservs.  If you would like to be removed from all NIH listservs, please go to (https://list.nih.gov/LISTSERV_WEB/signoff.htm) to unsubscribe.  If you would like to unsubscribe from a specific provider listserv, please go to (https://list.nih.gov/cgi-bin/show_list_archives) to unsubscribe or to leave the appropriate listserv. Please DO NOT respond to this email. This email is a service of CMS and routed through an electronic mail server to communicate Medicare policy and operational changes and/or updates. Responses to this email are not routed to CMS personnel. Inquiries may be sent by going to (http://www.cms.hhs.gov/ContactCMS). Thank you.

DME MAC Jurisdiction C News

 DME MAC Jurisdiction C News
E2399 – Power Wheelchair – Not Otherwise Classified Interface: Code E2399 describes an interface for a power wheelchair drive control system that is not described by any other HCPCS code. At the time of initial issue of a power wheelchair, this code would only be used for very uncommon types of drive control mechanisms – e.g., a fiber optic switch array. The DME MAC receives a number of claims in which code E2399 is used for various joystick "upgrades", including but not limited to the Pride Mobility Products Q-Logic Drive Control System or the Permobil R-net Remote Joystick. This is incorrect coding. Read more...
http://www.cignagovernmentservices.com/jc/pubs/news/2009/0709/cope10356_C.html
HCPCS Code A9283 - Devices Used for Edema or Ulcer Healing: HCPCS code A9283 (Foot pressure off loading/ supportive device, any type, each) was developed to describe various devices used for the treatment of edema or for a lower extremity ulcer or for the prevention of ulcers. When products are used solely to treat edema or ulcers or to prevent an ulcer of the lower extremity, suppliers should code them based on the patient s condition. Read more...
http://www.cignagovernmentservices.com/jc/pubs/news/2009/0709/cope10356_D.html
Please do not respond to this message. This is an unmonitored mailbox. Please use our Online Help Center to submit any comments and inquiries to CIGNA Government Services.

Jurisdiction B News: Surgical Dressings û Prepayment Review Update

 
 
 
 
Surgical Dressings � Prepayment Review Update The National Government Services Jurisdiction B Medical Review Department recently conducted a prepayment review for surgical dressings (HCPCS A6209 � A6214).  This is a widespread random selection of submitted claims from multiple suppliers which are reviewed for medical necessity. A total of 4,080 targeted services were reviewed and 3,795 (93.01%) of that total were denied.  In this review, a wide variety of issues were found.  A more in-depth article regarding this issue can be found on the NGS web site under Education and Support � Tools and Materials � Clinical Education.

 
 Remember! National Government Services' Jurisdiction B DME MAC List Serve is for out going messages only. Please do not respond back to messages as your response will not be answered, as this is not an authorized mode of communication at this time, Thank you!

CONFIDENTIALITY NOTICE: This E-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply E-mail and destroy all copies of the original message.
 To unsubscribe/change profile: click here.

Email list management powered by http://MailerMailer.com

Attention All CEDI Trading Partners, Suppliers, Billing Services, Clearinghouses, and Vendors: Delayed - National Government Services Schedules Web Site Outage

National Government Services Web Site Outage
Maintenance will not be performed on the www.NGSMedicare.com and www.ngscedi.com Web sites this Friday, July 31, 2009 as previously announced. System availability will not be affected by maintenance activity this weekend. An updated maintenance schedule will be communicated at a later date.  
Please contact the CEDI Help Desk for regarding any questions at ngs.cedihelpdesk@wellpoint.com or at 866-311-9184.
Thank you,
National Government Services, Inc.
Corporate Communications
 
If you want to update your profile or unsubscribe from any of our lists, you will first need to set up a password for your account. To do this, click on the Login link from the Listserv page on the www.NGSMedicare.com Web site, then select one of the following:
 
        Login - existing / transferred subscribers can obtain a new password and subscribe or unsubscribe from lists
        Manage Account - change personal information such as your address or phone number
        Join - new subscribers can create an account and subscribe to lists 
 
Please do not reply to this e-mail. National Government Services' Listserv is for outgoing messages only. Please do not respond back to messages as your response will not be answered, as this is not an authorized mode of communication at this time.
 CONFIDENTIALITY NOTICE: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information or otherwise be protected by law. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.

DME MAC A News for July 30, 2009 - HCPCS Code A9283 - DEVICES USED FOR EDEMA OR ULCER HEALING

 
NHIC, Corp.DME MAC A ListServeFor Immediate Release
 
July 30, 2009
HCPCS Code A9283 - DEVICES USED FOR EDEMA OR ULCER HEALINGHCPCS code A9283 (Foot pressure off loading / supportive device, any type, each) was developed to describe various devices used for the treatment of edema or for a lower extremity ulcer or for the prevention of ulcers.When products are used solely to treat edema or ulcers or to prevent an ulcer of the lower extremity, suppliers should code them based on the patient's condition. For example, walking boots are coded L4360 and L4386 when they are used as a brace for the treatment of orthopedic conditions. However, if walking boots are used solely for the prevention or treatment of a lower extremity ulcer or edema reduction, they shall be coded A9283.When using code A9283, there is no separate billing using addition codes. Replacement liners for devices billed with A9283 must be billed with code A9270 (noncovered item or service).The instructions in the Ankle-Foot, Knee-Ankle-Foot Orthoses LCD, Documentation Requirements section, concerning the use of the GY modifier no longer apply and will be deleted in a future revision of the policy.
 
  
 This email was sent to support@dmefree.com by nhic-dmemacwebmaster@eds.com.Update Profile/Email Address | Instant removal with SafeUnsubscribe | Privacy Policy.Email Marketing by
NHIC | 75 Sgt William Terry Drive | Hingham | MA | 02043

DME MAC A News for July 30, 2009 - Revised Article - IMPORTANT CHANGE - KX, GA, GZ and GY Modifiers - New Uses

 
NHIC, Corp.DME MAC A ListServeFor Immediate Release
 
July 30, 2009
REVISED ARTICLE - IMPORTANT CHANGE - KX, GA, GZ and GY Modifiers - New UsesThis is a revision of an article originally sent on July 22, 2009.
Many policies use the KX modifier to indicate compliance with specified coverage criteria. The following LCDs have revised instructions on modifier use. Refer to each policy for detailed guidance.Automatic External Defibrillators (Effective 09/01/2009)Cervical Traction Devices (Effective 09/01/2009)Commodes (Effective 09/01/2009)Epoetin (Effective 09/01/2009)High Frequency Chest Wall Oscillation Devices (Effective 10/01/2009)Home Dialysis Supplies and Equipment (Effective 09/01/2009)Hospital Beds (Effective 10/01/2009)Manual Wheelchair Bases (Effective 10/01/2009)Negative Pressure Wound Therapy Devices (Effective 10/01/2009)Orthopedic Footwear (Effective 10/01/2009)Positive Airway Pressure Devices (Effective 09/01/2009)Power Mobility Devices (Effective 10/01/2009)Refractive Lenses (Effective 10/01/2009)Respiratory Assist Devices (Effective 09/01/2009)Therapeutic Shoes for Persons with Diabetes (Effective 08/01/2009)The revised information is contained in the Documentation Section and outlines the use of additional modifiers to indicate that an item is statutorily noncovered or not medically necessary and whether or not a waiver of liability statement (i.e., Advance Beneficiary Notice of Noncoverage or ABN) is on file for an expected medical necessity denial.Proper use of the KX modifier expedites claim processing. Currently, an absent modifier causes a claim denial. However, increasing numbers of claims are submitted without the modifier resulting in a growing appeals volume. If the patient meets the criteria for use of the KX modifier but the supplier forgets to include it on the claim line, currently the supplier may request a reopening of the claim. This procedure requires manual intervention by the DME MAC and is responsible for a substantial workload for the contractor.Effective with these LCD revisions, the contractors will use the presence of a KX, GA, GZ or GY modifier to indicate whether the coverage criteria are or are not met. The DME MACs are implementing system edits that will now reject a claim line if the supplier does not include one of these modifiers as specified in each of these LCDs. If a claim line is rejected, the supplier may resubmit the claim line with the appropriate modifier. Requesting a reopening to correct a claim that is missing one of these modifiers will no longer be an available option.Since the KX modifier has a differing definition depending on the LCD requirements, suppliers should review the revised LCDs carefully to understand the proper use of the KX, GA, GZ or GY modifiers for each policy.Over the coming months, other LCDs that include use of the KX modifier will be updated to incorporate instructions for the use of the GA, GZ or GY modifiers.
 
  
 This email was sent to support@dmefree.com by nhic-dmemacwebmaster@eds.com.Update Profile/Email Address | Instant removal with SafeUnsubscribe | Privacy Policy.Email Marketing by
NHIC | 75 Sgt William Terry Drive | Hingham | MA | 02043

DME MAC A News for July 30, 2009 - Billing Reminder - Reopening Rejected Claims for Missing KX Modifiers

 
NHIC, Corp.DME MAC A ListServeFor Immediate Release
 
July 30, 2009
Billing Reminder - Reopening Rejected Claims for Missing KX ModifiersRequesting a reopening to correct a claim that is missing one of these modifiers will no longer be an available option.Effective for dates of service beginning August 1, 2009, the LCD for Therapeutic Shoes for Persons with Diabetes has revised instructions concerning the use of the KX and GY modifiers.Recently use of the GA, GY and GZ modifiers has been added to some policies to indicate that the relevant KX modifier requirements have not been met. Failure to use these modifiers correctly will result in a rejection.These changes will be effective for dates of service beginning September 1, 2009 for the following LCDs:Automatic External DefibrillatorsCervical Traction DevicesCommodesEpoetinHome Dialysis Supplies and EquipmentPositive Airway Pressure DevicesRespiratory Assist DevicesThese changes will be effective for dates of service beginning October 1, 2009 for the following LCDs:High Frequency Chest Wall Oscillating (HFCWO) DevicesHospital Beds and AccessoriesManual Wheelchair BasesNegative Pressure Wound Therapy (NPWT)Orthopedic FootwearPower Mobility DevicesRefractive LensesOther policies will add these modifiers over the coming months.Most claims denials occur as a result of a few common reasons. One of the most common is failure to add the KX modifier to a HCPCS code indicating that requirements specified in the medical policy have been met. In the past, these denials were often corrected either with a reopening or a redetermination request.Rejected claims must be corrected and resubmitted. Neither the reopening nor redetermination process is able to address rejected claims.Refer to each LCD for specific guidance on the use of these modifiers.
 
  
 This email was sent to support@dmefree.com by nhic-dmemacwebmaster@eds.com.Update Profile/Email Address | Instant removal with SafeUnsubscribe | Privacy Policy.Email Marketing by
NHIC | 75 Sgt William Terry Drive | Hingham | MA | 02043

DME MAC A News for July 30, 2009 - E2399 - Power Wheelchair - Not Otherwise Classified Interface

 
NHIC, Corp.DME MAC A ListServeFor Immediate Release
 
July 30, 2009
E2399 - Power Wheelchair - Not Otherwise Classified InterfaceCode E2399 describes an interface for a power wheelchair drive control system that is not described by any other HCPCS code. At the time of initial issue of a power wheelchair, this code would only be used for very uncommon types of drive control mechanisms - e.g., a fiber optic switch array.The DME MAC receives a number of claims in which code E2399 is used for various joystick "upgrades", including but not limited to the Pride Mobility Products Q-Logic Drive Control System or the Permobil R-net Remote Joystick. This is incorrect coding. Code E2399 (or K0108 - wheelchair component or accessory, not otherwise specified) must never be used for a component or feature of a joystick at the time of initial issue of a wheelchair.Reimbursement for a standard proportional remote joystick with a non-expandable controller is included in the allowance for a power wheelchair base. When a joystick with an expandable controller is provided at the time of initial issue, the following two codes are billed:E2313 - Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors, and mounting hardware, each

 E2377 - Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issueThe reimbursement for these two codes includes payment for any additional "upgrade" component or feature of a proportional or nonproportional joystick. Although separate billing is discouraged, if a supplier elects to bill separately, code A9900 (Miscellaneous DME supply, accessory, and/or service component of another HCPCS code) must be used.Claim lines for E2399 billed at the time of initial issue of a power wheelchair for an "upgrade" of a joystick or other drive control interface will be denied as not separately payable if they are billed with E2313 and/or E2377. If E2313 and E2377 are not billed, code E2399 will be rejected as incorrect billing.Refer to the Wheelchair Options and Accessories Policy Article for definitions of expandable and non-expandable controllers and various types of drive control interfaces. The Policy Article also contains guidance concerning the use of code E2399 for replacement components.Suppliers should contact the Pricing, Data Analysis, and Coding contractor (PDAC) for questions concerning the correct coding of specific products.
 
  
 This email was sent to support@dmefree.com by nhic-dmemacwebmaster@eds.com.Update Profile/Email Address | Instant removal with SafeUnsubscribe | Privacy Policy.Email Marketing by
NHIC | 75 Sgt William Terry Drive | Hingham | MA | 02043

Jurisdiction B News: LCD and Policy Article Revisions – Summary for July 2009

 
 
 
 
LCD and Policy Article Revisions – Summary for July 2009 Outlined below are the principal changes to several DME MAC Local Coverage Determinations (LCDs) and Policy Articles (PAs) that have been revised and posted.  Please review the entire LCD and each related Policy Article for complete information. High Frequency Chest Wall Oscillation DevicesLCDRevision Effective Date: 10/01/2009
INDICATIONS AND LIMITATIONS OF COVERAGE: 
Clarified:  Coverage criterion #2HCPCS CODES AND MODIFIERS:Added:  GA, GZRevised: KXDOCUMENTATION REQUIREMENTS:Added:  Instructions for GA and GZ modifiers  Hospital BedsLCDRevision Effective Date: 10/01/2009
HCPCS CODES AND MODIFIERS: 
Revised: KX modifierDOCUMENTATION REQUIREMENTS:Added: Instructions for the use of GA and GZ modifiers Policy ArticleRevision Effective Date: 10/01/2009
CODING GUIDELINES: 
Changed: SADMERC to PDAC  Infrared Heating Pad SystemsPolicy ArticleRevision Effective Date: 08/01/2009CODING GUIDELINES:Changed: SADMERC to PDAC  Intrapulmonary Percussive Ventilation SystemsPolicy ArticleRevision Effective Date: 08/01/2009
CODING GUIDELINES: 
Changed: SADMERC to PDAC  Manual Wheelchair BasesLCDRevision Effective Date: 10/01/2009HCPCS CODES AND MODIFIERS:Added: GA and GZ modifiersRevised KX modifierDOCUMENTATION REQUIREMENTS:Added: Instructions for use of GA and GZ modifiers Policy ArticleRevision Effective Date: 10/01/2009CODING GUIDELINES:Deleted E1161 from range of codes E1070-E1200Changed SADMERC to PDAC  Mechanical In-Exsufflation DevicesPolicy ArticleRevision Effective Date: 08/01/2009
CODING GUIDELINES: 
Changed: SADMERC to PDAC  Negative Pressure Wound TherapyLCDRevision Effective Date: 10/01/2009INDICATIONS AND LIMITATIONS OF COVERAGE:Added: Program Integrity Manual instructions on refills of suppliesChanged: SADMERC to PDACHCPCS CODES AND MODIFIERS:Added: GA and GZ modifiersRevised: KX modifierDOCUMENTATION REQUIREMENTS:Added: Instructions for the use of GA and GZ modifiersAPPENDICES:Revised pressure ulcer staging based on NPUAP guidelinesSOURCES OF INFORMATION AND BASIS FOR DECISION:Added:  Reference to NPUAP guidelines for pressure ulcer staging Policy ArticleRevision Effective Date: 10/01/2009CODING GUIDELINES:Changed SADMERC to PDAC  Orthopedic FootwearLCDRevision Effective Date: 10/01/2009HCPCS CODES AND MODIFIERS:Added: GY modifierRevised: KX modifierDOCUMENTATION REQUIREMENTS:Added: GY modifier instructions Policy ArticleRevision Effective Date: 10/01/2009CODING GUIDELINES:Revised: RT/LT modifier instructionsChanged: SADMERC to PDAC  Osteogenesis StimulatorsLCDRevision Effective Date: 08/01/2009DOCUMENTATION REQUIREMENTS:Included: Ultrasonic in statement regarding correct CMN to use for electrical osteogenesis stimulators Policy ArticleRevision Effective Date: 08/01/2009CODING GUIDELINES:Changed: SADMERC to PDAC  Parenteral NutritionLCDRevision Effective Date: 10/01/2009DOCUMENTATION REQUIREMENTS:Revised: Instructions for submitting a revised DIF Policy ArticleRevision Effective Date: 10/01/2009
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:Revised: DMERC to DME MACCODING GUIDELINES:Revised: SADMERC to PDAC  Power Mobility DevicesLCDRevision Effective Date: 10/01/2009HCPCS MODIFIERS:Added:  GA and GZ modifiersRevised:  KX modifierDOCUMENTATION REQUIREMENTS:Revised: Requirements for detailed product descriptionAdded: Instructions for use of the GA and GZ modifiers  Refractive LensesLCDRevision Effective Date: 10/01/2009
HCPCS MODIFIERS: 
Added:  GA and GZ modifiersRevised: KX modifierDOCUMENTATION REQUIREMENTS:Added:  Instructions for use of GA and GZ modifiers Policy ArticleRevision Effective Date:  10/01/2009
CODING GUIDELINES:Revised: RT/LT modifier instructions
Changed: SADMERC to PDAC  Note: The information contained in this article is only a summary of revisions to LCDs and Policy Articles.  For complete information on any topic, you must review the LCD and/or Policy Article.

 
 Remember! National Government Services' Jurisdiction B DME MAC List Serve is for out going messages only. Please do not respond back to messages as your response will not be answered, as this is not an authorized mode of communication at this time, Thank you!

CONFIDENTIALITY NOTICE: This E-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply E-mail and destroy all copies of the original message.
 To unsubscribe/change profile: click here.

Email list management powered by http://MailerMailer.com

Jurisdiction B News: A9283 – Devices Used For Edema or Ulcer Healing

 
 
 
 
A9283 – Devices Used For Edema or Ulcer Healing HCPCS code A9283 (Foot pressure off loading/ supportive device, any type, each) was developed to describe various devices used for the treatment of edema or for a lower extremity ulcer or for the prevention of ulcers. When products are used solely to treat edema or ulcers or to prevent an ulcer of the lower extremity, suppliers should code them based on the patient s condition.  For example, walking boots are coded L4360 and L4386 when they are used as a brace for the treatment of orthopedic conditions.  However, if walking boots are used solely for the prevention or treatment of a lower extremity ulcer or edema reduction, they shall be coded A9283.   When using code A9283, there is no separate billing using addition codes.  Replacement liners for devices billed with A9283 must be billed with code A9270 (noncovered item or service). The instructions in the Ankle-Foot, Knee-Ankle-Foot Orthoses LCD, Documentation Requirements section, concerning the use of the GY modifier no longer apply and will be deleted in a future revision of the policy.

 
 Remember! National Government Services' Jurisdiction B DME MAC List Serve is for out going messages only. Please do not respond back to messages as your response will not be answered, as this is not an authorized mode of communication at this time, Thank you!

CONFIDENTIALITY NOTICE: This E-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply E-mail and destroy all copies of the original message.
 To unsubscribe/change profile: click here.

Email list management powered by http://MailerMailer.com

Jurisdiction B News: IMPORTANT CHANGE - KX, GA, GZ and GY Modifiers - New Uses

 
 
 
 
IMPORTANT CHANGE - KX, GA, GZ and GY Modifiers � New Uses Many policies use the KX modifier to indicate compliance with specified coverage criteria.  The following LCDs have revised instructions on modifier use.  Refer to each policy for detailed guidance. Automatic External Defibrillators  (effective 9/1/09)Cervical Traction Devices  (effective 9/1/09)Commodes  (effective 9/1/09)Epoetin  (effective 9/1/09)High Frequency Chest Wall Oscillation Devices  (effective 10/1/09)Home Dialysis Supplies and Equipment  (effective 9/1/09)Hospital Beds  (effective 10/1/09)Manual Wheelchair Bases  (effective 10/1/09)Negative Pressure Wound Therapy Devices  (effective 10/1/09)Orthopedic Footwear  (effective 10/1/09)Positive Airway Pressure Devices  (effective 9/1/09)Power Mobility Devices  (effective 10/1/09)Refractive Lenses (effective  10/1/09)Respiratory Assist Devices  (effective 9/1/09)Therapeutic Shoes for Persons with Diabetes  (effective 8/1/09) The revised information is contained in the Documentation Section and outlines the use of additional modifiers to indicate that an item is statutorily noncovered or not medically necessary and whether or not a waiver of liability statement (i.e., Advance Beneficiary Notice of Noncoverage or ABN) is on file for an expected medical necessity denial. Proper use of the KX modifier expedites claim processing.  Currently, an absent modifier causes a claim denial.  However, increasing numbers of claims are submitted without the modifier resulting in a growing appeals volume.  If the patient meets the criteria for use of the KX modifier but the supplier forgets to include it on the claim line, currently the supplier may request a reopening of the claim.  This procedure requires manual intervention by the DME MAC and is responsible for a substantial workload for the contractor.  Effective with these LCD revisions, the contractors will use the presence of a KX, GA, GZ, or GY modifier to indicate whether the coverage criteria are or are not met.  The DME MACs are implementing system edits that will now reject a claim line if the supplier does not include one of these modifiers as specified in each of these LCDs.  If a claim line is rejected, the supplier may resubmit the claim line with the appropriate modifier. Requesting a reopening to correct a claim that is missing one of these modifiers will no longer be an available option. Since the KX modifier has a differing definition depending on the LCD requirements, suppliers should review the revised LCDs carefully to understand the proper use of the KX, GA, GZ or GY modifiers for each policy.  Over the coming months, other LCDs that include use of the KX modifier will be updated to incorporate instructions for the use of the GA, GZ, or GY modifiers.

 
 Remember! National Government Services' Jurisdiction B DME MAC List Serve is for out going messages only. Please do not respond back to messages as your response will not be answered, as this is not an authorized mode of communication at this time, Thank you!

CONFIDENTIALITY NOTICE: This E-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply E-mail and destroy all copies of the original message.
 To unsubscribe/change profile: click here.

Email list management powered by http://MailerMailer.com

Wednesday, July 29, 2009

CEDI Enrollment Forms Unavailable

 CEDI Enrollment Forms Unavailable
The CEDI Enrollment Forms on the CEDI website at www.ngscedi.com are currently unavailable. When submitting the form, the following error message is received:
"An error has occurred during your visit. The page you are attempting to access may not be available at this time. An error report has been issued to our technical team. Click here to return to the home page."
CEDI is working to resolve this issue as soon as possible.
Please direct any questions to the CEDI Help Desk at ngs.cedihelpdesk@wellpoint.com or 866-311-9184.
Please do not respond to this message. This is an unmonitored mailbox. Please use our Online Help Center to submit any comments and inquiries to CIGNA Government Services.

DME MAC Jurisdiction C News

 DME MAC Jurisdiction C News
Please do not respond to this message. This is an unmonitored mailbox. Please use our Online Help Center to submit any comments and inquiries to CIGNA Government Services.

DME MAC A News for July 29, 2009 - Register Today Before it is Too Late - 2009 DME MAC Jurisdiction A Symposiums

 
NHIC, Corp.DME MAC A ListServeFor Immediate Release
 
July 29, 2009
Register Today
Before it is Too Late!



2009 DME MAC Jurisdiction A Symposiums
Registration will be taken on a first come, first served basis until maximum capacity has been reached for each location. We are excited to be offering a dynamic range of topics and speakers. Some key speakers are from the Centers for Medicare and Medicaid Services (CMS), Competitive Bidding Implementation Contractor (CBIC), Comprehensive Error Rate Testing (CERT) Contractor, National Supplier Clearinghouse (NSC), and the Recovery Audit Contractor (RAC). In addition, the DME MAC A Medical Director will also be speaking during the general lunch session. Attendees will have the opportunity to interact directly with these various Medicare Contractors as well as State and National DMEPOS Associations in order to enhance their educational experience and get the most out of this excellent opportunity.A Symposium Web page is available on the DME MAC A Web site, which can be accessed at:
http://www.medicarenhic.com/dme/symposium/Symposium_General_Information.shtmlThis web page contains details and registration information. ListServe messages will be issued each time this page is updated. NHIC, Corp. DME MAC Jurisdiction A would like to extend this invitation to all interested Jurisdiction A suppliers.Please forward this information to all applicable individuals and keep watching for more details!
We look forward to seeing you there!
 
  
 This email was sent to support@dmefree.com by nhic-dmemacwebmaster@eds.com.Update Profile/Email Address | Instant removal with SafeUnsubscribe | Privacy Policy.Email Marketing by
NHIC | 75 Sgt William Terry Drive | Hingham | MA | 02043

Attention All CEDI Trading Partners, Suppliers, Billing Services, Clearinghouses, and Vendors: CEDI Enrollment Forms Unavailable

CEDI Enrollment Forms Unavailable
 
The CEDI Enrollment Forms on the CEDI Web site at www.ngscedi.com are currently unavailable.  When submitting the form, the following error message is received:
"An error has occurred during your visit. The page you are attempting to access may not be available at this time. An error report has been issued to our technical team. Click here to return to the home page."
 
CEDI is working to resolve this issue as soon as possible.
 
Please direct any questions to the CEDI Help Desk at ngs.cedihelpdesk@wellpoint.com or 866-311-9184.
 
Thank you,
National Government Services, Inc.
Corporate Communications
 
If you want to update your profile or unsubscribe from any of our lists, you will first need to set up a password for your account. To do this, click on the Login link from the Listserv page on the www.NGSMedicare.com Web site, then select one of the following:
 
        Login - existing / transferred subscribers can obtain a new password and subscribe or unsubscribe from lists
        Manage Account - change personal information such as your address or phone number
        Join - new subscribers can create an account and subscribe to lists 
 
Please do not reply to this e-mail. National Government Services' Listserv is for outgoing messages only. Please do not respond back to messages as your response will not be answered, as this is not an authorized mode of communication at this time.
 
 CONFIDENTIALITY NOTICE: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information or otherwise be protected by law. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.

Jurisdiction B News: Interactive Voice Response System CBT Course Now Available

 
 
 
 
Interactive Voice Response System Computer-Based Training Course is Now Available Medicare University is an educational program designed to provide a broad variety of Medicare information. Now available through Medicare University is the Interactive Voice Response (IVR) System computer-based training (CBT) course. The IVR system is a self-service tool that allows users to gain access to necessary claim information to complete their intake and billing processes. The IVR CBT will demonstrate primary features of the IVR system and provide helpful navigational tips. To access Medicare University for this new CBT, click on or paste the following link into your Internet browser www.medicareuniversity.com. Once in Medicare University, look for Catalog ID DME-C-0017. 

 
 Remember! National Government Services' Jurisdiction B DME MAC List Serve is for out going messages only. Please do not respond back to messages as your response will not be answered, as this is not an authorized mode of communication at this time, Thank you!

CONFIDENTIALITY NOTICE: This E-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply E-mail and destroy all copies of the original message.
 To unsubscribe/change profile: click here.

Email list management powered by http://MailerMailer.com

Jurisdiction B News: Transcript Summaries - Introduction to ICD-10-CM/PCS Call

 
 
 
 
Transcript Summaries - Introduction to ICD-10-CM/PCS for Physician Specialty Group Representatives Conference Call (200907-31A) The written and audio transcript summaries of the Introduction to ICD-10-CM/PCS for Physician Specialty Group Representatives Conference Call, which was conducted by the Centers for Medicare & Medicaid Services on June 23, 2009, are now available in the Downloads Section at: http://www.cms.hhs.gov/ICD10/06a_2009_CMS_Sponsored_Calls.asp

 
 Remember! National Government Services' Jurisdiction B DME MAC List Serve is for out going messages only. Please do not respond back to messages as your response will not be answered, as this is not an authorized mode of communication at this time, Thank you!

CONFIDENTIALITY NOTICE: This E-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply E-mail and destroy all copies of the original message.
 To unsubscribe/change profile: click here.

Email list management powered by http://MailerMailer.com

Transcript Summaries - Introduction to ICD-10-CM/PCS for Physician Specialty Group Representatives Conference Call

The written and audio transcript summaries of the Introduction to ICD-10-CM/PCS for Physician Specialty Group Representatives Conference Call, which was conducted by the Centers for Medicare & Medicaid Services on June 23, 2009, are now available in the Downloads Section at http://www.cms.hhs.gov/ICD10/06a_2009_CMS_Sponsored_Calls.asp .
-----------------------------------------------------------------------------------------------------------------
Note:  If you have problems accessing any hyperlink in this message, please copy and paste the URL into your Internet browser. 
If you received this message as part of the All FFS Providers listserv, you are currently subscribed to one of eighteen Medicare Fee-For-Service provider listservs.  If you would like to be removed from all NIH listservs, please go to (https://list.nih.gov/LISTSERV_WEB/signoff.htm) to unsubscribe.  If you would like to unsubscribe from a specific provider listserv, please go to (https://list.nih.gov/cgi-bin/show_list_archives) to unsubscribe or to leave the appropriate listserv. Please DO NOT respond to this email. This email is a service of CMS and routed through an electronic mail server to communicate Medicare policy and operational changes and/or updates. Responses to this email are not routed to CMS personnel. Inquiries may be sent by going to (http://www.cms.hhs.gov/ContactCMS). Thank you.

Jurisdiction B News: Take Action Now to Prepare for Competitive Bidding Program

 
 
 
 
Take Action Now to Prepare for the Medicare Durable Medical Equipment, Prosthetics, Orthotics,and Supplies (DMEPOS) Competitive Bidding Program! (200907-31) A Special Edition MLN Matters education article identifying steps suppliers should take in preparation for the DMEPOS Competitive Bidding Program to ensure successful bidder registration is available at http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0915.pdf. The article highlights specific sections of the CMS-855S, Medicare Enrollment Application, where the accuracy of the Authorized Official information and correspondence mailing address are critical for successful bidder registration.  The Centers for Medicare & Medicaid Services (CMS) urges suppliers planning to bid in the 2009 bidding cycle to read this article and make sure their most recent CMS-855S submission is still current and accurate.  

 
 Remember! National Government Services' Jurisdiction B DME MAC List Serve is for out going messages only. Please do not respond back to messages as your response will not be answered, as this is not an authorized mode of communication at this time, Thank you!

CONFIDENTIALITY NOTICE: This E-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply E-mail and destroy all copies of the original message.
 To unsubscribe/change profile: click here.

Email list management powered by http://MailerMailer.com

Jurisdiction B News Open Question & Answer Teleconference Registration Available

 
 
 
 
Registration Now Available for the Jurisdiction B DME MAC Ask-the-Contractor Teleconference Open Question and Answer Session National Government Services, the Jurisdiction B Durable Medical Equipment Medicare Administrative Contractor (DME MAC) will host an Ask-the-Contractor Teleconference (ACT) on Thursday, August 13, 2009 from 10:00 am until 11:00 am (ET). This teleconference will be an open question and answer session with all Jurisdiction B DME MAC departments represented including; Dr. Oleck the Medical Director, Provider Outreach and Education, Provider Outreach and Clinical Education, Appeals, Claims, Medical Review, Overpayment Recovery Unit, Systems and the Provider Contact Center. This teleconference is recommended for all Durable Medical Equipment (DME) suppliers who bill the Jurisdiction B DME MAC. We encourage all Medicare fee-for-service DMEPOS suppliers to sign up for this free educational opportunity.  Registration is available online only!  To register, please click on or paste the following link into an Internet browser:http://www.ngsmedicare.com/NGSMedicare/ADC/EventList.aspx?fromdate=5/28/2009&todate=5/28/2009&display=Day&type=public&eventidn=542&view=EventDetails&information_id=751">http://www.ngsmedicare.com/NGSMedicare/ADC/EventList.aspx?fromdate=8/1/2009&todate=8/31/2009&display=Month&type=public&eventidn=683&view=
EventDetails&information_id=891
 Registration InstructionsOnce you are on the "Events Calendar" page, click the link for the event for which you wish to register and follow these instructions:
 On the "Events Details page", click the icon above the dark blue line on the page that says "Register". A new screen will pop up entitled, "Event Registration Form", please fill out all required information and click <Next>.The "Event Registration Form-Confirmation" screen will appear.Verify your entries and click <Next> at the bottom of the registration screen.A new screen will appear, "Event Registration - Thank you!" to very successful registration.An email confirmation will immediately be sent to the email address you provided.Review and print the email confirmation - Do not delete the confirmation as it contains the dial in instructions. Note:  Once registration is complete, an e-mail confirmation will be sent and will include the dial-in information.  It is important that you save this e-mail confirmation in order to attend the ACT on August 13th. 

 
 Remember! National Government Services' Jurisdiction B DME MAC List Serve is for out going messages only. Please do not respond back to messages as your response will not be answered, as this is not an authorized mode of communication at this time, Thank you!

CONFIDENTIALITY NOTICE: This E-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply E-mail and destroy all copies of the original message.
 To unsubscribe/change profile: click here.

Email list management powered by http://MailerMailer.com

About this Blog

This blog shows most if not all of the announcements sent via the various email Mailservers.