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AAPC May 16, 2007
Edge Blast Header

Issue #77

Top Stories

Mandatory Use of the New CMS-1500 Form Is Around the Corner — Will You Be Ready?

Sequence Your Diabetes Codes Accurately

Anti-Cancer Vaccine Coming to A State Near You?

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 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 ( The UB-04 will retain the CMS-1450 designation.


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Torrey Kim

Torrey Kim, CPC
EdgeBlast editor

Top News

Mandatory Use of the New CMS-1500 Form Is Around the Corner — Will You Be Ready? By Jacqueline Thelian, CPC

Coding professionals may recall that CMS initially intended to implement its new CMS-1500 (Form 08-05) effective Jan. 1, 2007, but planned to also accept the old CMS-1500 (Form 12-90) through March 31 of this year. CMS set April 1, 2007 as the date after which Medicare payers would only accept the new form. However, due to incorrectly formatted versions of the new form currently on the market, CMS decided to extend the implementation date from April 1, 2007 to a targeted date of June 1, 2007.

It’s mid-May, so only a few weeks remain before your office must use the new CMS-1500 form. Will you be ready? Read on to find out some highlights of what will be required on the new form.


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Sequence Your Diabetes Codes Accurately By Maria Calderon, CPC

Code selection for diabetes is very important — physicians who provide services to these patients deserve to get paid, and the coding rules can be different than coding other diseases.

One of the most prevalent diagnosis coding problems that causes denied claims is truncated diagnosis coding, and this is particularly common with diabetes coding.

As with all diagnoses, diabetes should be coded to the highest level of specificity. In some cases, this may mean that the practice submits several diagnosis codes on the claim form, but these codes all help paint a more complete picture for the insurer.

When coding diabetes with manifestations, you must assign the code(s) from category 250.xx first, followed by the manifestation codes. Assign as many codes from category 250.xx with as many manifestations codes necessary to fully describe the patient’s diabetic condition.


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Anti-Cancer Vaccine Coming To A State Near You? By Constance Valdez, CPC, CCP, RMC

Recently, Texas Governor Rick Perry issued an executive order requiring all girls ages 11 to 12 to be vaccinated against the Human Papillomavirus (HPV, 079.4) before entering the sixth grade. The governor’s order is supposed to take effect in September, 2008.

HPV is a common virus that causes genital warts and cervical cancer. We are all quite familiar with mandatory immunization of schoolchildren, such as measles diphtheria, polio, etc. However, mandatory immunization against a sexually transmitted disease took many Texans by surprise.


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The EdgeBlast Wants Your Articles!

The EdgeBlast 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 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: #76). 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. As of which date must you begin using the new CMS-1500 form?


2. The HPV vaccine is approved for females in which age range?


3. A diabetic patient presents complaining of polyneuropathy. What two diagnoses should you report and in what order?


4. What goes in box 33a of the new CMS-1500 form?


5. What is the administration code for the HPV vaccine?


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PQRI Audio Lecture

CMS Officials Terrence L. Kay and Sylvia Publ Explain PQRI - Hear it from the Source

Terrence L. Kay

PQRI Audio Lecture
June 15, 2007

Special: $99 for the first 300 attendees!

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