Jurisdiction B News: Power Mobility Devices – 7-Element Order

 

Power Mobility Devices â€" 7-Element Order Medicare national and local policy specify that following completion of the face-to-face examination, the physician or treating practitioner must complete a written order containing seven specified elements.  Suppliers have the option of providing physicians with a form that lists the seven elements, but which requires the physician to provide all of the requested information.  One example of such a form is: Beneficiary name:  ____________________________________________Item ordered:  ________________________________________________Date of face-to-face examination:  _________________Diagnosis/condition relating to need for item:  __________________________________________________________________________________________________________Length of need:  ________________________________Physician signature:____________________________ Signature date:_________________ It is not permissible for the supplier to lead the physician as to the type of equipment that is ordered.  Some examples, not all-inclusive, of unacceptable 7-element orders are:A form with power mobility device already entered in Item Ordered field.A form with check-off boxes for various types of mobility assistive equipment.A 7-element order with these or similar elements will be considered invalid and the claim for the power mobility device will be denied.  Refer to the Power Mobility Devices Local Coverage Determination and Policy Article for additional information on coverage and documentation.

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.

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Jurisdiction B News: Male External Catheter – A4326 – Article Retired

 

Male External Catheter – A4326 – Article Retired The recently published article on Male External Catheter – A4326 – Coding and Utilization Guidelines has been retired.

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.

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Jurisdiction B News: CERT Errors - Oxygen

 

CERT Errors - Oxygen The Comprehensive Error Rate Testing (CERT) contractor has been identifying a significant number of errors on claims for oxygen equipment.  Most of the errors are due to insufficient documentation to support the medical necessity for the billed items.  Based on reports received by the DME MACs, the documentation that the CERT contractor is looking for includes: Most recent CMN prior to the date of service (DOS) on the claimReport of the qualifying oximetry or arterial blood gas test listed on the CMNPhysician visit note within 30 days prior to the initial certification date documenting the diagnosis for which the oxygen is prescribedPhysician visit note with 90 days prior to the recertification date (if applicable)For claims subsequent to the recertification date, physician visit note supporting continued medical monitoring of oxygen use and needsWhen suppliers receive a request from the CERT contractor on an oxygen claim, it is important to assure that all of these documents are included in the response.  If any of these documents is not provided, it will likely result in a request for overpayment on the claim.

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.

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ICD-10-CM/PCS Medicare Severity - Diagnosis Related Group Conversion Project National Provider Conference Call

ICD-10-CM/PCS

Medicare Severity - Diagnosis Related Group

Conversion Project

 National Provider Conference Call

 

When:

Thursday, November 19, 2009

12:30 p.m. - 2:00 p.m. Eastern Standard Time (EST)

 

Discussion Topics and Materials:

This outreach call describes the preliminary exercise the Centers for Medicare & Medicaid Services (CMS) undertook to convert data using the General Equivalence Mappings (GEM). The GEMs are a tool that was developed to assist CMS and other data users who need to convert ICD-9-CM data or payment systems to the relevant ICD-10-CM/PCS codes and

ICD-10-CM/PCS codes back to the relevant ICD-9-CM codes. The following topics will be discussed during the conference call:

·        How ICD-9-CM based Medicare Severity - Diagnosis Related Group (MS-DRG), version 26.0, were converted to ICD-10-CM and ICD-10-PCS codes; and

·        The best way to use the GEMs in converting data.

 

To access the ICD-10-CM/PCS Medicare Severity - Diagnosis Related Group Conversion Project Presentation that will be discussed during this conference call, visit http://www.cms.hhs.gov/ICD10/06a_2009_CMS_Sponsored_Calls.asp and select the title of the presentation in the Downloads Section. 

 

Registration:

In order to receive call-in information, you must register for the conference call. Please note that if you are planning to sit with a group, only one person needs to register to receive the call-in data. This registration is solely to reserve a phone line, NOT to allow participation.

 

Registration will close at 12:30 p.m. EST on November 18, 2009 or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time. To register for the conference call:

·        Visit http://www.eventsvc.com/palmettogba/111909 ;

·        Fill in all required data;

·        Verify that your time zone is displayed correctly in the drop down box; and

·        Select "Register."

 

You will be taken to the "Thank You for Registering" Page and an e-mail confirmation will be sent to you shortly thereafter. Note:  Please print and save the registration page in the event that your server blocks confirmation e-mails. If you do not receive the confirmation e-mail, please check your spam/junk mail filter as the confirmation may have been directed there.

 

For those who will be unable to attend, written and audio transcripts will be posted shortly after the conference call in the Downloads Section at http://www.cms.hhs.gov/ICD10/06a_2009_CMS_Sponsored_Calls.asp . 

_____________________________________________________________________________________

Flu Season is upon us!  CMS encourages providers to begin taking advantage of each office visit to encourage your patients with Medicare to get seasonal flu shots.  Flu shots are their best defense against combating flu this season.  And don't forget—health care workers also need to protect themselves.

 

Medicare provides coverage of the flu vaccine without any out-of-pocket costs to the Medicare patient as a part B benefit.  No deductible or copayment/coinsurance applies.  Note that influenza vaccine is NOT a Part D covered Drug.

 

For more information about Medicare's coverage of the seasonal influenza vaccine and its administration, as well as related educational resources for health care professionals, please go to http://www.cms.hhs.gov/MLNProducts/35_PreventiveServices.asp on the CMS website. 

 

For information on Medicare policies related to H1N1 influenza, please go to http://www.cms.hhs.gov/H1N1 on the CMS website.

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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: Common Electronic Data Interchange (CEDI) Documents Updated

 

Common Electronic Data Interchange (CEDI) Documents Updated CEDI has updated the following documents on the Web site www.ngscedi.com to include information about the NCPDP 5.1 Implementation: CEDI Frequently Asked Questions: This document contains answers to questions frequently asked by suppliers contacting the CEDI Help Desk. It has been updated to include information concerning the NCPDP 5.1 Implementation, the Express Plus software conversion, and Ordering/Referring Provider warning edits. CEDI NCPDP Error Code Manual: This document contains information concerning edits received on the CEDI Front-End Report when submitting NCPDP claims after November 8, 2009. Companion Document: The Companion document provides information regarding the following transactions; the 837 claim format, the 835 remittance notice, the 276/277 transactions, and the National Council for Prescription Drug Programs (NCPDP) claim format. This is intended as a reference to be used in addition to the ANSI ASC X12 Implementation Guides and NCPDP reference documents.  The Companion Document has been updated to include information about the NCPDP 5.1 Implementation. The CEDI Frequently Asked Questions and CEDI NCPDP Error Code Manual can be accessed at the following link http://www.ngscedi.com/outreach_materials/outreachindex.htm. The Companion Document is located on the Technical Specifications page at http://www.ngscedi.com/TechnicalSpec/techindex.htm. For more information, please contact the CEDI Help Desk at ngs.cedihelpdesk@wellpoint.com or at 866-311-9184.

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.

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Jurisdiction B News: Common Electronic Data Interchange (CEDI) Documents Updated

 

Common Electronic Data Interchange (CEDI) Documents Updated CEDI has updated the following documents on the Web site www.ngscedi.com to include information about the NCPDP 5.1 Implementation: CEDI Frequently Asked Questions: This document contains answers to questions frequently asked by suppliers contacting the CEDI Help Desk. It has been updated to include information concerning the NCPDP 5.1 Implementation, the Express Plus software conversion, and Ordering/Referring Provider warning edits. CEDI NCPDP Error Code Manual: This document contains information concerning edits received on the CEDI Front-End Report when submitting NCPDP claims after November 8, 2009. Companion Document: The Companion document provides information regarding the following transactions; the 837 claim format, the 835 remittance notice, the 276/277 transactions, and the National Council for Prescription Drug Programs (NCPDP) claim format. This is intended as a reference to be used in addition to the ANSI ASC X12 Implementation Guides and NCPDP reference documents.  The Companion Document has been updated to include information about the NCPDP 5.1 Implementation. The CEDI Frequently Asked Questions and CEDI NCPDP Error Code Manual can be accessed at the following link http://www.ngscedi.com/outreach_materials/outreachindex.htm. The Companion Document is located on the Technical Specifications page at http://www.ngscedi.com/TechnicalSpec/techindex.htm. For more information, please contact the CEDI Help Desk at ngs.cedihelpdesk@wellpoint.com or at 866-311-9184.

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.

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DME MAC Jurisdiction C News

 LAST DAY TO REGISTER FOR THE ROUND 1 REBID OF THE DMEPOS COMPETITIVE BIDDING PROGRAM

 Reminder: If you are a supplier interested in participating in the Round 1 Rebid of the Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) competitive bidding program, you must register today (November 4, 2009) before 9:00 p.m. EST. Suppliers that do not register cannot bid and are not eligible for contracts. Read more...
http://www.cignagovernmentservices.com/jc/pubs/news/2009/1109/cope10966.html

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