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Medicare Compliance & Reimbursement

TRANSMITTALS:

Start Billing For Diabetes Self-Management Training

Published on Mon Jan 22, 2007

Bonus: Use this code for lumbar artificial disk replacement.

Medicare will cover 10 hours of initial self-management training for a patient diagnosed with diabetes, and another two hours per year after that, according to Transmittal 1158 (CR 5433). You should bill using G0108 or G0109 with Type of Bill 73X.

In other recent transmittals:

· Don't use Category III code 0091T for lumbar artificial disk replacement (LADR) starting Jan. 1. Instead, you should be using new CPT code 22857, according to Transmittal 1164 (CR 5462).

· If your zip code falls into more than one "payment locality," you'll have to start submitting nine-digit zip codes on your claims starting Oct. 1, 2007. Otherwise, you could be facing denials or delays in payment, warns Transmittal 1167 (CR 5208).

In some cases, the five-digit zip code may mislead your carrier into believing your service happened in a different county.

· Starting Jan. 1, your carrier will apply a 25-percent copayment to colorectal screenings in the ambulatory surgical center (ASC) setting, says Transmittal 1160 (CR 5387).
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