In Billing
Oct 14th, 2011
Effective for dates of service on or after Sept. 1, 2011 Palmetto GBA will cover the percutaneous insertion of an endovascular cardiac assist device and the device itself. “The impella has the capacity of being inserted into the heart from a peripheral location (femoral/axillary/iliac artery). The location of insertion is dictated by the patient anatomy. While ...
In Audit
Sep 16th, 2011
If you’re having a hard time getting Medicare to pay for radiologic chest examinations claims, you’re in good company. In Southern California alone, Palmetto GBA recently reported a 46.3 percent charge denial rate. And that was just between the months of February and April of this year. The Jurisdiction 1 Medicare administrative contractor (J1-MAC) recently ...
In CMS
Sep 16th, 2011
Retroactive effective Aug. 11, 2011 Palmetto GBA will reimburse services for Doppler-guided hemorrhoid artery ligation with or without retro-anal repair for Grade II or III hemorrhoids that have failed rubber band ligation or conservative treatment. Conservative treatments include behavior modification, high fiber diets to control constipation, and hydrocortisone cream or suppositories. Use CPT® co...
In Billing
Aug 31st, 2011
Providers who submit claims for monthly end stage renal disease (ESRD) services (e.g., CPT® codes 90951 through 90966) should be aware of how to complete the Days/Units and Dates of Service (DOS) fields, reminds jurisdiction 1 Part B Medicare administrative contractor Palmetto GBA. Days/Units Enter ‘1’ for the month ANSI 5010 electronic claims: Loop 2400, Segment ...
In CMS
May 31st, 2011
You may know which code accurately describes a physician’s services for test materials and equipment for home international normalized ratio (INR) monitoring and review, but you’ll need more than just the right code to get paid for such services. Jurisdiction 1-Medicare administrative contractor (J1-MAC) Palmetto GBA recently published a provider education article on its website ...