May 1st, 2009
Providers submitting claims to Cigna: Make sure to read the private payer’s latest Professional Claims Code Editing and Documentation Requirements Guidelines. Effective April 27, the company now requires supporting documentation for some claims containing modifiers 25 and 59. Cigna: 25 and 59 Require Documentation was last modified: May 1st, 2009 by admin aapc...
In Billing
Apr 30th, 2009
Comments Off on Eye Global Surgery E/M Services Under Scrutiny
The Centers for Medicare & Medicaid Services (CMS) reimbursed physicians approximately $1.6 billion for major eye global surgeries performed in 2005. About $97.6 million of those Medicare payments were for evaluation and management (E/M) services included in eye global surgery fees that were more than likely not provided during global surgery periods, according to an ...
In Coding
Apr 30th, 2009
Comments Off on FDA Approves Japanese Encephalitis Vaccine
The U.S. Food and Drug Administration (FDA) approved, March 30, a new vaccine to prevent Japanese encephalitis virus (JEV). IXIARO®, manufactured by Austrian drug maker Intercell AG, is the only vaccine for JEV in the United States. FDA Approves Japanese Encephalitis Vaccine was last modified: April 30th, 2009 by admin aapc...
Apr 29th, 2009
Comments Off on Incorrect Units Reporting Adds Up to Costly Mistake
A North Carolina fiscal intermediary incorrectly paid 89 of 91 Medicare claims for oxaliplatin services reviewed in an Office of Inspector General (OIG) audit. Prior to the April 23 report, implicated hospitals had already identified and refunded $1,762,070 in overpayments to Palmetto GBA. The OIG has requested Palmetto GBA recapture the remaining overpayments totaling $160,096. ...
Apr 28th, 2009
Comments Off on DMEPOS Competitive Bidding Program Delayed
At the Obama administration’s request, the interim final rule on the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program went into effect April 18. The rule—issued by the Centers for Medicare & Medicaid Services (CMS) on Jan. 16—implements provisions in section 154 of the 2008 Medicare Improvements for Patients and Providers Act ...