In Billing
Feb 10th, 2012
Treatment of endometrial hyperplasia with the insertion of a hormone-containing intrauterine device (IUD) is an accepted method to manage endometrial hyperplasia for patients with abnormal uterine bleeding who are unable to tolerate, or at high risk for complications of, oral megestrol, states Palmetto GBA in its February 2012 Medicare Advisory. The jurisdiction 1 Medicare administrative ...
In Billing
Apr 15th, 2011
Palmetto GBA has determined thermal capsulorrhaphy not medically necessary due to the lack of clinical evidence to demonstrate improved health outcomes. The Medicare administrative contractor (MAC) announced April 7 that claims submitted for this service will be denied. Also known as thermal coagulation of joints, radiofrequency thermal shrinkage, electrothermal assisted capsulorrhaphy (ETAC) and ...
In CMS
Jan 28th, 2011
Palmetto GBA announced Jan. 25 that certain ambulance claims submitted since the first of the year for particular HCPCS Level II codes with a super rural ZIP code indicator of  ‘B’ may have been underpaid. Providers in Ohio, West Virginia, Hawaii, Nevada, Northern California, and South California may be affected. Transportation Services codes A0426-A0429 and A0433-A0434 ...
In CMS
Aug 27th, 2010
Palmetto GBA recently amended its Cataract Surgery Local Coverage Determinations (LCDs) to reflect a focus on the adult patient and a more complete description of functional status. In response to comments the J1 Part A/B Medicare administrative contractor (MAC) received, the title of the final policy was amended to appropriately reflect the adult patient population. ...
In Billing
Aug 27th, 2010
Palmetto GBA, Medicare administrative contractor (MAC) for jurisdiction 1 (J1), recently reported that the Comprehensive Error Rate Testing (CERT) contractor reported an increase in errors for complete blood counts (CBC) and urinalysis (UA) laboratory services. According to the CERT report, data indicate two types of common errors: Code selection errors Standard protocol use in place ...