AAPC April 18, 2007
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Issue #75

Top Stories

AAPC Conference Hosts 2,100 Attendees in Seattle

Medicare Reveals Most Common Billing Errors

Medical Supply Payment Isn’t Always Out of Reach

The Edge Blast Wants Your Articles!


Test Yourself

UB-92 Use Ends May 22

The UB-92 will not be accepted by CMS after May 22, 2007.
The National Uniform Billing Committee (NUBC) is replacing the UB-92 with the UB-04 paper form. The Health Insurance Portability and Accountability Act (HIPAA) requires submission of National Provider Identifiers (NPIs) on claims effective May 23, 2007, and the UB-92 does not have a field for reporting of NPIs. During the period March 1, 2007 through May 22, 2007, providers that use paper forms for claim submission will be able to submit either the UB-92 or the UB-04 form.
More information about the transition is available from the NUBC Web site (http://www.nubc.org/). The UB-04 will retain the CMS-1450 designation.


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Torrey Kim Top News

by Torrey Kim, CPC

AAPC Conference Hosts 2,100 Attendees in Seattle

Attendees at the recent AAPC National Conference in Seattle certainly had something to cheer about: over 60 educational sessions, scores of exhibits to visit and review, networking roundtables according to medical specialty or by local chapter, and much, much more.

The conference not only offered coding professionals an opportunity to learn from educational sessions, but also allowed them to share insight with one another.

"The national conference is an excellent networking and educational opportunity," says Stephanie L. Jones, EMS, CPC, vice president of member services at the AAPC. "We have phenomenal speakers, and our attendees benefit from a tremendous amount of information over a four day period."

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Medicare Reveals Most Common Billing Errors

A recent Medlearn Matters article outlined the most frequent errors in claims submitted to Medicare, and the answers may surprise some coders.

Among the most common errors:
  • The referring (or ordering) physician's name/identification number was not listed in areas 17/17a of the claims — this information is essential for diagnostic services and consults.
  • E/M codes and their places of service didn’t match.
  • Diagnosis codes were invalid or truncated.
  • An inaccurate provider number was entered — or in some cases, practices that didn’t have an NPI or UPIN simply filled in zeroes where the number should have been.

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Medical Supply Payment Isn’t Always Out of Reach

Coding professionals who want to collect for the medical supplies that their physicians use should review the HCPCS Level II codes. In order to bill supplies to Medicare, the practice will either have to apply with the durable medical equipment (DME) Regional Carrier System (DMERC) to be able to dispense and bill for DME supplies, or in some cases, bill the supplies directly to the carrier.

For example, suppose a surgeon applies a fiberglass cast to a 27-year-old patient with a lower leg fracture. The coding professional should report the appropriate fracture care or casting code, along with Q4038 (Cast supplies, short leg cast, adult [11 years +], fiberglass).

Reimbursement for cast supplies, as is the case with all supplies, depends on carrier guidelines. Many payers will only reimburse for the supplies in certain circumstances, whereas other insurers may not reimburse the practice at all. Check with your insurer for specific payment guidelines.

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The Edge Blast Wants Your Articles!

The Edge Blast and the Cutting Edge are always looking for articles from our AAPC members. If you would like to contribute an article for either of these publications, please contact our editor, Torrey Kim, CPC at torrey.kim@aapc.com. We’re hoping to hear from you!

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Test Yourself

By answering the following questions you can earn .5 continuing education units to apply toward your annual AAPC certification renewal. Simply answer the questions and send in a copy of your work when submitting your CEU package. Include the number of each EdgeBlast on your submission (example: #75). The number is available at the top of the page.

Answers to the questions are not always found directly (word for word) in the EdgeBlast in which they appear. While often related to the EdgeBlast content, they require additional resources such as your ICD-9-CM, CPT® and HCPCS manuals.

1. What will happen if you fill out box 32 of your Medicare claim form, but write the word "SAME" in box 33?

Answer:

2. A nurse gives a Synvisc shot to an elderly patient suffering from shoulder osteoarthritis. Which HCPCS and CPT® codes should the practice bill?

Answer:

3. Can the practice separately bill for a bandage applied following an injection?

Answer:

4. The physician treats a patient with unspecified primary thrombocytopenia. Which ICD-9-CM code should be reported?

Answer:

5. 5. What does "DME" stand for?

Answer:

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