Part B Insider (Multispecialty) Coding Alert

Published on Thu Nov 10, 2005 PDF

If you treated undocumented aliens during May or June, you have until Jan. 11 to submit claims to Medicare under a special pilot program.

The Centers for Medicare & Medicaid Services extended the deadline for claims under the "Section 1011" program (named after a section of the Medicare Modernization Act) by a couple of weeks. So far, CMS hasn't received too many payment requests for undocumented aliens, officials told the Dec. 6 physician Open Door Forum. Other news from the Forum:

• Expect shortages of influenza vaccine to be alleviated soon. CMS is releasing more vaccine in a tiered fashion, and all doses should be released by the end of December.  Keep vaccinating people through the end of March.

• So far, CMS has released 300,000 national provider identifier (NPI) numbers to providers. Starting Jan. 3, you can include your NPI on your claims form, but you must list your existing UPIN as your primary identifier and your NPI as your secondary identifier. Medicare will require existing UPINs until October, and accept them until May 2007. You can use "bulk enumeration" to add multiple providers from the same practice at once, instead of individually.

• CMS doesn't have the authority to impose a single national process for appeals on prescription drug plans for the new Medicare Part D drug benefit. In some cases, patients may have to appeal denials via phone, fax or letter.

• Physicians are still having a hard time finding affordable supplies of intravenous immune globulin (IVIG) despite the added payments that CMS put in place. IVIG manufacturers have toll-free numbers to help you obtain emergency supplies, CMS officials said. CMS recommended that physicians join group-purchasing organizations to obtain IVIG.