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Michelle Dick
EdgeBlast Editor |
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Renée Dustman
EdgeBlast Author |
Top News
Time to Correct Your NPI Records to Prevent Denied Claims
Health care providers now have free access to a searchable database for National Provider Identifier (NPI) data to facilitate billing for consultations. The NPI Registry made its debut September 4, 2007 and is available online at the NPI Registry website. Also available from this site, providers can download the latest NPI information file. The Centers for Medicare and Medicaid Services (CMS) intends to fully update this file each month.
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Medicare Clinical Trial Policy Revisions Clarify and Enhance Coverage
Recent changes to the Medicare Clinical Trial Policy (CTP) clarify that “routine costs,” for which providers can submit claims, include investigational items or services used in the context of a qualifying clinical trial, if otherwise covered outside the trial. Also covered are “reasonable and necessary” items and services used to diagnose and treat complications that ensue from participation in a clinical trial.
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Revisions to Portable X-ray Services
The Code of Federal Regulations (CFR) citation numbers have changed. What were once known as 405.11-405.14 and 405.16, are now 486.100 (a)-(d), 486.110 (a)-(b), 486.104 (a)-(b12) and (c), 486.106 (a)-(c), 486.108 (a)-(k), and 486.10 (a)-(b).
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Test Yourself
- Earn .5 CEUs
By answering the following questions, you can earn .5 continuing education units to apply toward your annual AAPC certification renewal. Simply answer the questions and send in a copy of your work when submitting your CEU package. Do put the number of each EdgeBlast included in your submission. The number is available at the top of the page.
Answers to the questions are not always found directly (word for word) in the EdgeBlast in which they appear. While often related to the EdgeBlast content, they require additional resources such as your ICD-9-CM, CPT® and HCPCS manuals.
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What happens if you are still using legacy NPI numbers in your claims? |
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When should a denied claim be resubmitted? |
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According to CTP what are investigational items or services used in a clinical trial classified as? |
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Through what process does CMS determine items and services to be considered “reasonable and necessary?" |
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What has been deleted from Appendix D, Guidance to Surveyors for Portable X-ray Services? |
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