In Billing
Jun 18th, 2012
Billing and coding guidelines for prostate molecular marker claims submitted to Palmetto GBA have changed. The Part B Medicare administrative contractor (MAC) for jurisdiction 1 (American Samoa, California, Guam, Hawaii, Nevada, and Northern Mariana Islands) has determined the service to be medically unnecessary and will not reimburse physicians for HOXD3, PTEN, and ERG molecular markers. ...
In Billing
Mar 16th, 2012
There  reportedly has been a high incidence of crossover claims being rejected. According to Palmetto GBA, many physician offices and durable medical equipment (DME) suppliers are receiving provider notification letters from their servicing Medicare administrative contractor (MAC) or carrier that includes an H40142 error code and the description “Discharge date (DTP-01=096) was not expected b...
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
Jan 27th, 2012
Providers and suppliers have until March 31 to comply with the new Health Insurance Portability and Accountability Act (HIPAA) transaction standards for submitting claims electronically, and can even opt out and continue to submit paper-based claims if they so choose. If they want to get paid, however, they’ll have to accept the wave of the future. ...
In Billing
Oct 28th, 2011
The Oncotype DX® Colon Cancer Assay meets criteria for analytical and clinical validity and clinical utility as a reasonable and necessary Medicare benefit, Palmetto GBA announced after completing a recent assessment. Effective Sept. 18, 2011 the jurisdiction 1 Part B Medicare administrative contractor (J1-B MAC) says it will reimburse Oncotype DX® Colon Cancer Assay services ...