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Issue #166 - February 2, 2011
AAPC EdgeBlast

CMS Launches Redesigned Medicare Coverage Database
The Centers for Medicare & Medicaid Services (CMS) announced Jan. 27 the launching of its newly redesigned Medicare Coverage Database (MCD) website.

The MCD contains all current National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs), local articles, proposed coverage decisions, National Coverage Analyses (NCAs), Coding Analyses for Labs (CALs), Medicine Evidence Development and Coverage Advisory Committee (MEDCAC) proceedings, and Medicare coverage guidance documents.

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Palmetto: Super Rural Ambulance
Claims Underpaid

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.

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Home Health Claims for Oxygen Equipment on Hold
The Centers for Medicare & Medicaid Services (CMS) instructed regional home health intermediaries (RHHIs), Jan. 21, to hold claims where the revenue codes for both portable and stationary oxygen equipment rentals appear on the same claim. A systems error is preventing these claims from being processed and paid correctly.

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Dx Codes Eligible for Co-morbidity
Pay Revised

Two ICD-9-CM diagnosis codes are no longer eligible for a co-morbidity payment adjustment under the End-Stage Renal Disease Prospective Payment System (ESRD PPS). In fact, they never really were eligible.

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Researchers: EHR Doesn't Improve Care
Two researchers at Stanford University, Palo Alto, Calif., say their research shows the use of electronic health records (EHRs) doesn't improve the quality of care after all, countering one of the major arguments for adoption.

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MedPAC: End Free Ride for Home Health
Medicare beneficiaries who receive home health services face hefty copays in the near future if Congress takes up a recent recommendation from its own advisory committee. A transcript prepared by Medicare Payment Advisory Commission (MedPAC) staff recommends cost sharing to resolve regional variations in spending and use among Medicare services, particularly among post-acute services, identified in the committee's January 2011 report to Congress.

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OIG Offers Free Compliance Workshops
Free half-day training on compliance best practices is available through the Office of Inspector General (OIG) in six cities beginning Feb. 16. The trainings will be offered in the following places:

  • Houston, Texas — February 16
  • Tampa, Fla. — March 2
  • Kansas City, Mo. — March 23
  • Baton Rouge, La. — April 12
  • Denver, Colo. — May 3
  • Washington, DC — May 18
Enroll via the Centers for Medicare & Medicaid Services (CMS). Workshops have limited seating.

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Coding Tips

CMS Clarifies Modifier KY Use
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Code Home Oxygen Use for Cluster Headaches
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Medical News

Osteoporosis Screening Recommendation Updated
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Drugmaker Recalls Six Lots of Acetadote
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Payers Scouring Social Media for Cheaters
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Indiana Hospital Reveals Security Breach
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Featured Items
CMS Redesigns Database
Ambulance Claims
Oxygen Equipment Claims
Dx Codes Revised
EHR Doesn't Improve Care
MedPAC: End Free Ride
OIG: Free Workshops
Coding Tips

Medical News
Coding Job Links

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